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4.2.3. Tobacco Products
COR LOE
Recommendations
1 A 1. In patients with CCD, tobacco use should be assessed at every
health care visit to facilitate identification of those who may
benefit from behavioral or pharmacologic interventions.*
1 A 2. Patients with CCD who regularly smoke tobacco should be
advised to quit at every visit.*
1 A 3. In patients with CCD who regularly smoke tobacco,
behavioral interventions are recommended to maximize
cessation rates in combination with pharmacotherapy,
including bupropion, varenicline, or combination long- and
short-acting nicotine replacement therapy (NRT).*
2b B-R 4. In patients with CCD who regularly smoke tobacco,
varenicline may be considered versus bupropion or NRT to
increase cessation rates.
2b B-R 5. In patients with CCD who regularly smoke tobacco, the
short-term use of nicotine-containing e-cigarettes may be
considered to aid smoking cessation, although the risk of
sustained use and unknown long-term safety may outweigh
the benefits.
3: Harm B-NR 6. Patients with CCD should avoid secondhand smoke exposure
to reduce risk of cardiovascular events.*
* Modified from the 2019 ACC/AHA guideline on the primary prevention of cardiovascular
disease. Arnett DK, et al. op. cit.
