A Review of Community Pharmacy-Based Pharmacologic Interventions and Methods for Smoking Cessation

Background: The aim of this study was to provide an overview of the published peer-reviewed literature related to community pharmacy-based smoking cessation counseling efforts in the United States and Canada. Methods: Electronic databases, Embase, PubMed and Medline, were searched for articles from January 2002 to January 2012. Keywords used were smoking cessation, pharmacist, pharmacologic, pharmacy, and multidisciplinary. Studies were excluded if they were conducted outside of the United States and Canada. Results: Twenty-six articles were included in this review with subtopics pharmacist and patient perception of pharmacy-based counseling, pharmacologic interventions, and methods for pharmacist led smoking cessation counseling. Literature review suggests both patients and pharmacists have positive views on smoking cessation counseling by a pharmacist. Studies show that counseling related to pharmacologic interventions is preferred. Specifically, patients prefer a non-confrontational approach by pharmacists. Although the 2008 Clinical Practice Guidelines, Treating Tobacco Use and Dependence, recommend an intensive intervention approach due to a strong dose-response relationship between the session length and successful treatment outcomes, pharmacists are unlikely to use an intensive intervention. Pharmacists should perform brief counseling sessions by assessing a patient’s willingness to quit and then motivating, educating, and referring them to an available resource. These brief sessions should be done in person and performed at each visit. Conclusions: Pharmacists are encouraged to develop or adopt a system of tracking codes for smoking cessation counseling as efforts towards reimbursement increase in the future. Evidence suggests that cost reduction and improved health outcomes can occur when smoking cessation counseling is provided in the community pharmacy setting. Future research should examine reimbursement for pharmacistprovided counseling.