Korean J Fam Med.  2024 Mar;45(2):69-81. 10.4082/kjfm.23.0142.

Evidence-Based Guideline for the Treatment of Smoking Cessation Provided by the National Health Insurance Service in Korea

Affiliations
  • 1Department of Family Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea
  • 2Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea
  • 3Department of Family Medicine, Wonkwang University Sanbon Hospital, Gunpo, Korea
  • 4Department of Family Medicine and Health Promotion Center, Hallym University Sacred Heart Hospital, Anyang, Korea
  • 5Department of Family Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
  • 6Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Bucheon St. Mary’s Hospital, Bucheon, Korea
  • 7Department of Family Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
  • 8Department of Psychiatry, Hanyang University Hospital, Seoul, Korea
  • 9Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
  • 10Department of Psychiatry, Seoul National University Hospital, Seoul, Korea
  • 11Division of Cardiology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea

Abstract

Although major countries, such as South Korea, have developed and disseminated national smoking cessation guidelines, these efforts have been limited to developing individual societies or specialized institution-based recommendations. Therefore, evidence-based clinical guidelines are essential for developing smoking cessation interventions and promoting effective smoking cessation treatments. This guideline targets frontline clinical practitioners involved in a smoking cessation treatment support program implemented in 2015 with the support of the National Health Insurance Service. The Guideline Development Group of 10 multidisciplinary smoking cessation experts employed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE)-ADOLOPMENT approach to review recent domestic and international research and guidelines and to determine evidence levels using the GRADE methodology. The guideline panel formulated six strong recommendations and one conditional recommendation regarding pharmacotherapy choices among general and special populations (mental disorders and chronic obstructive lung disease [COPD]). Strong recommendations favor varenicline rather than a nicotine patch or bupropion, using varenicline even if they are not ready to quit, using extended pharmacotherapy (>12 weeks) rather than standard treatment (8–12 weeks), or using pharmacotherapy for individuals with mental disorders or COPD. The conditional recommendation suggests combining varenicline with a nicotine patch instead of using varenicline alone. Aligned with the Korean Society of Medicine’s clinical guideline development process, this is South Korea’s first domestic smoking cessation treatment guideline that follows standardized guidelines. Primarily focusing on pharmacotherapy, it can serve as a foundation for comprehensive future smoking cessation clinical guidelines, encompassing broader treatment topics beyond medications.

Keyword

Dependence; Pharmacotherapy; Smoking; Tobacco; Guideline
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