Cognitive Behavioral Therapy and Pharmacotherapy for the Treatment of Tobacco Use Disorder in Primary Care for Resident Physicians

Abstract

Introduction Though the prevalence of smoking has decreased, it remains the second leading risk for early death and disability worldwide. At the primary care level, the combined use of behavioral interventions and pharmacotherapy has been shown to be more effective in reduction of smoking. Among behavioral interventions, cognitive behavioral therapy (CBT) provides a useful framework for helping patients quit smoking. Methods This 90-minute workshop was led by two facilitators, a general internist who practices as a primary care physician and a clinical psychologist with content expertise in CBT. This pairing provided complementary perspectives to allow for learner engagement. To evaluate the workshop, we used a pre-/postsurvey that was administered at the beginning and the end of the workshop. Participants were asked how often they incorporated (presurvey) and intended to incorporate (postsurvey) CBT as part of smoking cessation counseling in their clinical practices. Results There was a statistically significant change in learners' perceived usefulness of CBT for smoking cessation from pre- to postworkshop. Discussion Our workshop is a unique contribution to the literature. Limitations of our study include not knowing the long-term effect of knowledge acquisition or decay. Our future direction will be to produce training that applies CBT to other common chronic diseases that have a huge behavioral component in primary care, such as insomnia, chronic pain, and obesity.

Cognitive Behavioral Therapy for Treatment of Insomnia in Primary Care for Resident Physicians

“…As such, there was no variability to analyze pre and post. This ceiling effect was likely due to the fact that residents had had some previous exposure to CBT in previous workshops (e.g., one led by these facilitators on smoking cessation 13 ). Despite residents' initial awareness of the utility of CBT, we still observed increases in their intentions to incorporate CBT into their treatment of patients with insomnia and in their comfort with various components of this care after participating in the workshop.…”

Análise prognóstica de um programa de tabagismo entre pacientes com comorbidade psiquiátrica

“…A indústria do tabaco, por exemplo, resiste focando suas estratégias de incentivo ao fumo na população mais vulnerável e por meio de novos atrativos (Cavalcante, 2005). Além disso, países de baixa e média renda e alguns subgrupos da população ainda são negligenciados pelas ações de políticas públicas, como a população em extrema pobreza (Baggett;Tobey;Rigotti, 2013;McDougal et al, 2019), a população carcerária (Richmond et al, 2009;Schroeder;Morris, 2010), a população de mulheres e outras identidades de gênero, de níveis socioeconômicos e educacionais menos favorecidos (Amos et al, 2011;Higgins et al, 2015;Drope et al, 2018;McDougal et al, 2019), além da população psiquiátrica (Ziedonis et al, 2008;Schroeder;Morris, 2010;Prochaska;Young-Wolf, 2017;Ziedonis;Larkin, 2017;McDougal et al, 2019). Outro agravante é o fato de o tabagismo ser uma doença de difícil controle e, para muitos casos, precisa de tratamento especializado.…”

“…As abordagens psicossociais no tabagismo envolvem todas as intervenções não medicamentosas direcionadas para a cessação ou redução do uso do tabaco em todos os níveis de atenção. indivíduo lidar com os sintomas de abstinência, identificação de situações de risco, solução de problemas e elaboração de estratégias de enfrentamento, manejo de estresse e técnicas de relaxamento (Schroeder;Morris, 2010;Loreto et al, 2017;McDougal et al, 2019). A TCC é o modelo de intervenção de referência para o tratamento do tabagismo, podendo ser combinada ou não com estratégias medicamentosas (Nunes et al, 2011;Prochaska;Benowitz, 2019).…”