The American Academy of Family Physicians (AAFP) has been a strong champion for tobacco prevention and has promoted evidence-based strategies for tobacco cessation. To support this work, it has developed a wide range of educational resources and practice support tools to help family physicians and their care teams.

INTRODUCTION

Tobacco use remains the leading cause of preventable death in the United States with more than 480,000 lives lost annually to cigarette smoking alone, including 41,000 deaths caused by secondhand smoke. There are many benefits from tobacco cessation, including decrease in mortality from heart disease and stroke; decrease in the risk of cancer in multiple organ systems; decrease in the loss of lung function; decrease in the risk of chronic obstructive pulmonary disease (COPD); benefits for the health of pregnant patients, their fetuses, and newborns; and an overall improved quality of life. Smoking cessation counseling and pharmacotherapy are cost-effective means to reduce or prevent disease, more than doubling the rate of cessation compared with placebo.

ROLE OF TELEHEALTH

While in-person, office-based cessation initiatives remain effective, telehealth is rapidly becoming an alternative modality for patient care. Telehealth services have allowed limited exposure among patients and medical staff during the COVID-19 pandemic. Medicaid, Medicare, and some private insurance carriers expanded the use of telehealth due to the public health emergency.

Telehealth can provide video clinical services that supplement those provided by state-based tobacco quitlines (e.g., 1-800-QUIT-NOW). These services expand access and improve adherence to chronic care management, such as treating tobacco dependence, and provide physicians enhanced methods of delivering evidence-based treatment.

Creating a team that assists the physician in delivering telehealth tobacco cessation services may be useful, particularly in counseling, behavioral change approaches, treatment modalities, and follow-up aspects of care. A recent study showed that telehealth can be effective in tobacco cessation treatment with similar abstinence rates as in-person counseling. Telehealth may provide increased patient satisfaction and adherence to the pharmacotherapy treatment when compared to telephone counseling. Telehealth counseling can also help patients feel better supported by their physicians as they attempt to quit smoking. Compared with telephone counseling, telehealth video services allow clinicians to assess non-verbal cues from patients, which enhances the impact and accuracy of counseling encounters.

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