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Smoking cessation guidelines: evidence-based recommendations of the French Health Products Safety Agency

Published online by Cambridge University Press:  16 April 2020

B. Le Foll ,
P. Melihan-Cheinin ,
G. Rostoker ,
G. Lagrue  and
for the working group of AFSSAPS
B. Le Foll*
Affiliation:
Preclinical Pharmacology Section, Behavioral Neuroscience Research Branch, National Institute on Drug Abuse, National Institutes of Health, Department of Health and Human Services, 5500 Nathan Shock Drive, Baltimore, MD21224, USA
P. Melihan-Cheinin
Affiliation:
Direction Générale de la Santé, Paris, France
G. Rostoker
Affiliation:
AFSSAPS, French Health Products Safety Agency, Saint-Denis, 143/147, boulevard Anatole France, 92285Saint-Denis cedex, France
G. Lagrue
Affiliation:
Centre de tabacologie, hôpital Albert-Chenevier, Creteil, France
*
*Corresponding author. E-mail address: [email protected] (B. Le Foll).
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Abstract

Tobacco use is the leading preventable cause of death in developed countries. Millions of smokers are willing to stop, but few of them are able to do so. Clinicians should only use approaches that have demonstrated their efficacy in helping patients to stop smoking. This article summarizes the evidence-based major findings and clinical recommendations for the treatment of tobacco dependence of the French Health Products Safety Agency (AFSSAPS). Clinicians should enquire about the smoking status of each patient and provide information about health consequence of smoking and effective treatments available. These treatments include counseling (mainly individual or social support and behavioral and cognitive therapy) and pharmacological treatment with either nicotine replacement therapy (NRT) or bupropion LP. Pharmacological treatments should be used only for proven nicotine dependence, as assessed by the Fagerstrom test for Nicotine Dependence. The choice of pharmacologic treatment depends of the patient's preference and history and of the presence of contra-indications. The clinician should start with a single agent, but these treatments may be used in combination. Smoking behavior is a chronic problem that requires long-term management and follow-up. Access to intensive treatment combining pharmacological treatment and extensive behavioral and cognitive therapy should be available for highly dependent patients.

Keywords

Tobacco dependenceRecommendationsTreatmentNicotine replacement therapyBuproprionReview
Type
Review
Information
European Psychiatry , Volume 20 , Issue 5-6 , August 2005 , pp. 431 - 441
Copyright
Copyright ©Elsevier SAS 2005

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