This page has information on clinical care topics for health professionals, including dosing and duration of nicotine replacement therapy and best practices in tobacco control within the VA.

• Pocket Guide for Clinicians
• Clinical Practice Guidelines and Quick Reference Guide for Clinicians
• Tobacco Use Cessation Treatment Guidance
• Smoking Cessation Medications and Nicotine Replacement Therapy
• Online Resources for Veterans 
• Health Effects of Exposure to Secondhand Smoke
• Consumer Health Information Regarding E-Cigarettes

Pocket Guide for Clinicians

This pocket guide provides brief guidance on the 5 A’s of smoking cessation counseling: Ask, Advise, Assess, Assist, and Arrange.

• Helping Smokers Quit: A Guide for Clinicians (172 KB, PDF)

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Clinical Practice Guidelines and Quick Reference Guide for Clinicians

These guidelines provide clinical guidance to VA health care providers on evidence-based tobacco use cessation interventions, including brief counseling, pharmacotherapy, telephone counseling, intensive treatment, and recommendations for cessation with specialty populations. The guidelines reflect a population-based approach to tobacco cessation as a major public health challenge. 

• U.S. Public Health Service Clinical Practice Guideline - Treating Tobacco Use and Dependence: 2008 Update (2.1 MB, PDF)*
  • For the first time, the full guideline is available in Spanish* (2.3 MB, PDF)
• A quick reference guide is available:  Quick Reference Guide for Clinicians (2008 Update) - Treating Tobacco Use and Dependence (1.1 MB, PDF)

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Tobacco Use Cessation - Treatment Guidance

Download VHA's three part Tobacco Use Cessation - Treatment Guidance.  Includes easy to use flowcharts and a table detailing treatment options. 

• Part 1: Guidance on the 5 A's (Ask, Advise, Assess, Assist, Arrange) (233 KB, PDF)
• Part 2: Assisting with Tobacco Cessation - Medication Options, provides guidance on what options to try first and what to do if there is a relapse (250 KB, PDF)
• Part 3: Medications for Tobacco Use Cessation, a table listing medication descriptions, pros/cons, limitations, and dosing recommendations (1.9 MB, PDF)

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Smoking Cessation Medications and Nicotine Replacement Therapy

A wide variety of FDA-approved nicotine replacement therapies and smoking cessation medications are available in the VA formulary.

• VA Clinical Guidance/Criteria for Use (Varenicline):  Look for "Varenicline Criteria for Prescribing" link located near the bottom of the page (Updated July 2011)
• VA Formulary Choices for Pharmacotherapy of Smoking Cessation (Updated December 2009) (103 KB, PDF)
• Varenicline and Bupropion Safety Warnings from FDA* (Issued July 2009)

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Online Resources for Veterans

The "Quit Tobacco, make everyone proud"*†  Web site is now available to Veterans through a VA partnership with the Department of Defense/TRICARE.  This site includes online tools, personalized quit plans and live chat services.  Veterans should click on the "VA Veterans" link to access these resources. 

Posters and a wallet card is available to remind Veterans about this on-line resource.

• Poster, 11" x 17", light background (815 KB, PDF)
• Poster, 11" x 17", dark background (443 KB, PDF)
• Wallet card, front and back (257 KB, PDF)

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Health Effects of Exposure to Secondhand Smoke

The Health Consequences of Involuntary Exposure to Tobacco Smoke:  A Report of the Surgeon General was released on June 27, 2006, and increases our understanding of the very serious health effects of exposure to secondhand smoke. Read major conclusions.

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Consumer Health Information Regarding E-Cigarettes

The Food and Drug Administration has posted consumer information about the potential health risks of e-cigarettes: FDA Warns of Health Risks Posed by E-Cigarettes* (434 KB, PDF)

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