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What Can Be Accomplished in an Office Visit? Updates on New Medications and the Power of the Brief Intervention for Patients With Nicotine Addiction
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Case Study #1: Mary
55 years old with recent diagnosis of mild chronic obstructive pulmonary disease (COPD)
Case Study #2: Greysen
55-year-old male comes into your office seeking help with pulmonary problems, apparently related to smoking
Case Study #3: Jane
49-year-old woman presents with mild URI and tobacco use of 2 packs per day
Read Case Studies Now
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Accreditation Statement
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Cedars-Sinai Medical Center and The Partnership for Medical Education. Cedars-Sinai Medical Center is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
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Credit Designation Statement
Cedars-Sinai Medical Center designates this educational activity for a maximum of .75 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Please note: to earn up to 2.0 AMA PRA Category 1 Credits™, you must participate in both the Web conference and follow-up case studies.
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Course Description
The purpose of this activity is to provide clinicians with training on the treatment of nicotine dependence, including pharmacotherapy and BCIs. The program will increase the familiarity of PCPs with the medication options available and emphasize the 5As of the AHQR guideline. Experts will present and explain the prevalence and impact of nicotine dependence followed by a detailed discussion of pharmacotherapy and BCIs for nicotine dependence. The participants will have the opportunity to incorporate what they have learned by working through case studies at their convenience following the Web conference. Overall, the Web conference and follow up case studies will improve clinicans’ abilities to manage nicotine dependence through education on the use of medications and BCIs.
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Learning Objectives
At the conclusion of the activity, participants should be able to:
- Recognize the impact of nicotine dependence on comorbid health conditions to decrease smoking-related illnesses in patients.
- Incorporate a medication to reduce risk of nicotine craving and withdrawal symptoms into an overall nicotine dependence treatment plan.
- Incorporate an effective brief clinical intervention to reduce risk of nicotine craving and withdrawal symptoms into an overall nicotine dependence treatment plan.
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Who Should Attend
This activity is designed for primary care physicians, psychiatrists, advanced practice nurses, physician assistants, and other healthcare professionals interested in improving their skills on treating patients with nicotine dependence.
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Faculty
Jeffery N. Wilkins, MD
Course Director
Lincy, Heyward-Moynihan Chair in Addiction Medicine,
Vice Chair, Department of Psychiatry and Behavioral Neurosciences
Cedars-Sinai Medical Center
Adjunct Professor of Psychiatry and Behavioral Sciences,
David Geffen School of Medicine at UCLA
Los Angeles, California
Douglas M. Ziedonis, MD, MPH
Professor and Chairman,
Department of Psychiatry
University of Massachusetts Medical School
UMass Memorial Health Care
Worcester, Massachusetts
Mitchell A. Nides, PhD
President, Los Angeles Clinical Trials
Director, "Picture Quitting", The Entertainment Industry's Quit Smoking Program
Los Angeles, California
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Disclosure of Potential Conflicts of Interest
It is the policy of Cedars-Sinai Medical Center to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. Cedars-Sinai Medical Center assesses conflict of interest with its faculty, planners, and managers of CME activities. Conflicts of interest that are identified are resolved by reviewing that presenter’s content for fair balance and absence of bias, scientific objectivity of studies utilized in this activity, and patient care recommendations.
While Cedars-Sinai Medical Center endeavors to review faculty content, it remains the obligation of each physician or other healthcare practitioner to determine the applicability or relevance of the information provided from this course in his or her own practice. In accordance with the policy of Cedars-Sinai, faculty are asked to disclose any affiliation or financial interest that may affect the content of their presentations. The presenting faculty reported the following:
- Jeffery N. Wilkins, MD is a Consultant and/or on a Speaker’s Bureau for Alkermes, Inc.
- Douglas M. Ziedonis, MD, MPH, is a Consultant and/or on a Speaker’s Bureau for Alkermes, Inc., Bristol-Myers Squibb Company, Cephalon, Inc., Janssen Pharmaceutica Products, LP, and Pfizer Inc.
- Mitchell A. Nides, PhD, is a Consultant and/or on a Speaker’s Bureau for Pfizer Inc. and has done Contracted Research for GlaxoSmithKline and Pfizer Inc.
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Disclosure of Planner and Reviewer Relationships
- Emmanuel Saltiel, PharmD, has no real or apparent conflicts of interest to report
- Stephanie A. VanDyke, MS, has no real or apparent conflicts of interest to report
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Disclosure of Unlabeled/Unapproved Uses of Drugs or Devices
NOTICE: The audience is advised that faculty members do not intend to reference unlabeled or unapproved uses of drugs in their presentations.
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Jointly sponsored by Cedars-Sinai Medical Center and
The Partnership for Medical Education.
Supported by an educational grant from Pfizer Inc.
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Acknowledgement of Commercial Support
Cedars-Sinai Medical Center gratefully acknowledges the educational grant from Pfizer Inc. in support of this activity.
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Biographies
Jeffery N. Wilkins, MD
Course Director
Lincy, Heyward-Moynihan Chair in Addiction Medicine,
Vice Chair, Department of Psychiatry and Behavioral Neurosciences
Cedars-Sinai Medical Center
Adjunct Professor of Psychiatry and Behavioral Sciences,
David Geffen School of Medicine at UCLA
Los Angeles, California
Jeffery N. Wilkins, MD, is the Lincy/Heyward-Moynihan Endowed Chair in Addiction Medicine and Vice Chair of the Department of Psychiatry and Behavioral Neurosciences at Cedars-Sinai Medical Center in Los Angeles, California. Dr. Wilkins is also Medical Director of Addiction Medicine and Director of Addiction Studies within the department's Clinical Trials Unit, and he is Program Director for the Accreditation Council for Graduate Medical Education-approved Fellowship in Addiction Psychiatry. In addition, he is an Adjunct Professor of Psychiatry and Behavioral Sciences at David Geffen School of Medicine at the University of California, Los Angeles (UCLA).
Dr. Wilkins' research interests include pharmacotherapy of patients with substance abuse problems and/or mental illness, the pharmacokinetics of substances of abuse, and the identification of biological markers for psychiatric disorders. His investigations have received funding from the National Institute on Drug Abuse, the National Institute of Mental Health, and the Veterans Administration. Dr. Wilkins is also evaluating innovative techniques in substance abuse prevention in adolescents and children, including the use of health-oriented video games.
Dr. Wilkins received his MD from the University of California, San Diego (UCSD) School of Medicine. After studying neurology at Queen Square and St. Pancras Hospitals in London, he completed an internship in Medicine at UCSD School of Medicine and a residency in Psychiatry at the UCLA Neuropsychiatric Institute. A board-certified psychiatrist, Dr. Wilkins is a Diplomate of the American Board of Medical Examiners and the American Board of Psychiatry and Neurology, from which he has also received added qualifications in Addiction Psychiatry. He is a Distinguished Fellow of the American Psychiatric Association and is certified by the American Society of Addiction Medicine. He has written articles for numerous peer-reviewed publications, including the American Journal of Psychiatry, Archives of General Psychiatry, Biological Psychiatry, California Pediatrician, and the Journal of Drug and Alcohol Dependence.
Douglas M. Ziedonis, MD, MPH
Professor and Chairman,
Department of Psychiatry
University of Massachusetts Medical School
UMass Memorial Health Care
Worcester, Massachusetts
Douglas M. Ziedonis, MD, MPH, is currently Professor and Chair of the Department of Psychiatry at the University of Massachusetts Medical School and UMass Memorial Health Care. He has served as Director of the Division of Addiction Psychiatry at the Robert Wood Johnson Medical School, Co-Director of the University of Medicine and Dentistry of New Jersey Tobacco Dependence Program, and Director of the Addiction Research Program at the Cancer Institute of New Jersey.
Dr. Ziedonis is an internationally recognized leader in co-occurring mental illness and addiction. He holds a particular interest in tobacco dependence, and he is leading and advising several national initiatives in this area, including within the Robert Wood Johnson Foundation, the Veterans Affairs Healthcare System, and the American Psychiatric Association. He has worked with addiction and mental health treatment providers, agencies, and national organizations to better understand and address tobacco use among individuals with mental illness and other comorbid conditions.
Dr. Ziedonis has served as an advisor to President Bush’s New Freedom Commission on Mental Health and he currently serves as a Senior Fellow for the Substance Abuse and Mental Health Services Administration’s Co-Occurring Disorders Center for Excellence and the Treatment Improvement Protocols on Co-Occurring Disorders. He has served on the American Psychiatric Association’s Practice Guidelines Work Group on Substance Use Disorders and Council on Addictions. He currently receives grants from the National Institute on Drug Abuse on Addressing Tobacco Through Organizational Change in Addiction Settings, Motivational Enhancement Therapy for Poly-Drug Addiction, and Smoking Cessation Treatments for Individuals With Schizophrenia.
Dr. Ziedonis has written more than 100 book chapters and peer-reviewed publications and co-edited three books and five behavioral therapy manuals for co-occurring disorders. He serves on the editorial board of The American Journal of Drug and Alcohol Abuse, Journal of Groups in Addiction & Recovery, and Journal of Substance Abuse Treatment.
Mitchell A. Nides, PhD
President, Los Angeles Clinical Trials
Director, "Picture Quitting", The Entertainment Industry's Quit Smoking Program
Los Angeles, California
Mitchell A. Nides, PhD, is President of Los Angeles Clinical Trials, which specializes in clinical trials of smoking cessation treatments.
Dr. Nides has been the principal investigator on dozens of smoking cessation trials testing such nicotine replacement therapies as nicotine gum, patch inhaler, and nasal spray, as well as such nonnicotine compounds as bupropion, varenicline, and rimonabant. He is also the director and principal investigator of the entertainment industry’s smoking cessation program, “Picture Quitting.” This program provides state-of-the-art group, individual, and telephone smoking cessation services to entertainment industry workers and their families in Southern California. From 1987-1999, Dr. Nides was also a researcher in the Pulmonary and Critical Care Department of the University of California, Los Angeles (UCLA) School of Medicine. He served as the Intervention Director of the UCLA Lung Health Study, a National Heart Lung and Blood Institute-funded multicenter intervention trial testing the effectiveness of smoking cessation and several inhaled medications in slowing the progression of chronic obstructive pulmonary disease. Using group sessions and individual follow-up, combined with extensive and extended use of nicotine gum, the study was able to achieve very high long-term quit rates.
Over the years, Dr. Nides has trained thousands of physicians, pharmacists, nurses, and other healthcare professionals on ways to help their patients stop smoking. In June 1998, he cohosted, along with former US Surgeon General C. Everett Koop, a live smoking cessation satellite broadcast to smokers across the country. Dr. Nides has authored numerous articles on smoking cessation in such journals as JAMA, The New England Journal of Medicine, Archives of Internal Medicine, Addiction, Nicotine & Tobacco Research, and American Journal of Health Behavior.
Dr. Nides received his PhD in Counseling Psychology from the UCLA School of Education. He is a member of the board of directors of the Society for Research on Nicotine and Tobacco.
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Bibliography
Blondal T, Gudmundssom LJ, Olafsdottir I, et al. Nicotine nasal spray with nicotine patch for smoking cessation: randomised trial with six year follow up. BMJ. 1999;318(7179):285-288.
Hughes JR, Stead LF, Lancaster T. Antidepressants for smoking cessation. Cochrane Database Syst Rev. 2002;(1):CD000031.
Jorenby DE, Leischow SJ, Nides MA, et al. A controlled trial of sustained-release bupropion, a nicotine patch, or both for smoking cessation. N Engl J Med. 1999;340(9):685–691.
Kornitzer M, Boutsen M, Dramaix M, Thijs J, Gustavsson G. Combined use of nicotine patch and gum in smoking cessation: a placebo-controlled clinical trial. Prev Med. 1995;24(1):41-47.
National Cancer Institute. Risks Associated with Smoking Cigarettes with Low Machine-Measured Yields of Tar and Nicotine. Monograph 13. US Department of Health and Human Services; 2001.
Puska P, Korhonen H, Vartiainen E, et al. Combined use of nicotine patch and gum compared with gum alone in smoking cessation: a clinical trial in North Karelia. Tob Control. 1995;4:231-235.
Silagy C, Mant D, Fowler G, et al. Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev. 2000;(3):CD000146.
Simmons M, Connett JE, Nides MA, et al. Smoking reduction and the rate of decline in FEV(1): results from the Lung Health Study. Eur Respir J. 2005;25(6):1011-1017.
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