Developing Comprehensive Support Systems for Dual Users of Cigarettes and E-Cigarettes: Targeted Initiatives to Facilitate Successful Cessation

Dual users are smokers who use both regular cigarettes and e-cigarettes. This group needs special help because the ways they get addicted can be different for each product. Regular cigarettes give nicotine through burning, which creates harmful chemicals. E-cigarettes also give nicotine, but they have their own health risks and can cause dependence.

Using both products at the same time can make quitting harder. For example, some may smoke cigarettes in certain places but use e-cigarettes where smoking is not allowed. This can make it confusing to set clear quitting goals. Doctors and health workers need to design treatments that handle both the physical addiction and the habits related to these products.

Helping dual users stop smoking needs support systems that think about all parts of their tobacco use.

Targeted Behavioral and Pharmacological Interventions

The National Institute on Drug Abuse (NIDA) says the best way to treat tobacco addiction is to use both behavior therapy and FDA-approved medicines. These medicines include nicotine replacement therapies (NRT) like patches, gums, lozenges, sprays, and inhalers. There are also prescription drugs such as bupropion and varenicline.

Behavioral therapies like Cognitive Behavioral Therapy (CBT), Motivational Interviewing (MI), and mindfulness help people find triggers, change how they think, and avoid relapses. For people using both cigarettes and e-cigarettes, these therapies must be adjusted to cover both types of use.

Studies show that when behavior therapy is combined with medicines, quitting is more successful than using only one method. NRT alone can raise quit rates by 50 to 70 percent. Using two NRT methods together, such as patches plus gum, works even better. Medications like varenicline, which affect how nicotine works in the brain, often do better than bupropion or single NRT methods when given with counseling. This approach treats both the body’s cravings and the mind’s habits at the same time.

Cessation Support through Telephone Quitlines and Technology

Telephone quitlines are easy to use and low cost ways to get help quitting tobacco. They offer free counseling and support, which works best when people use three or more sessions. In 2018, quitlines helped over 11,000 people stop using tobacco. They serve many kinds of people well.

For dual users, quitlines can give advice that fits the challenges of quitting both cigarettes and e-cigarettes. They can help users stay on track for both products.

Technology is becoming more important in quitting smoking. Apps, text message programs, websites, and social media help reach more people. These tools work well for younger adults, many of whom use e-cigarettes.

Research shows that using technology helps people quit 1.5 times better than no help or self-help alone. Digital tools give real-time help and track progress, which encourages good habits.

Addressing Disparities: Rural Versus Urban Tobacco Cessation Needs

Studies by the University of Wisconsin–Madison’s Center for Tobacco Research and Intervention (UW-CTRI) show there are big differences between rural and urban areas in using healthcare and quitting tobacco. People in rural places often face more problems like fewer doctors, trouble with transportation, and less access to quitting help.

Programs in places like rural Milwaukee demonstrate the value of working with local communities and reaching out specifically to groups with higher needs. UW-CTRI’s BREATHE study focuses on helping underserved groups with quitting tobacco, showing a model that covers many needs.

Health managers and IT staff in rural healthcare should keep these differences in mind when building quitting programs. Using telehealth and mobile health tools can help get around distance problems and make sure everyone has fair access.

Special Considerations for Populations with Mental Illness and Vulnerable Groups

People with mental illness often use tobacco more and have special troubles quitting. They may stop going to regular quitting programs and face other health problems. This means they need a different approach.

UW-CTRI trains behavioral health workers to include tobacco quitting in mental health care. Combining these treatments supports patients better and helps more people quit.

Prisons also have a lot of tobacco use. But quitting treatments there often lag behind. Using proven quitting programs made for people in jail can lower health problems and help them fit back into society.

For people using both cigarettes and e-cigarettes, it is important to understand the special needs of these groups. Treatments must combine medicines and behavior help while thinking about mental health and life situations.

Emerging Treatments and Their Role in Cessation

New quitting treatments include technologies like transcranial magnetic stimulation (TMS) and personalized medicine based on genetics.

Repetitive TMS (rTMS) is a way to stimulate the brain without surgery. It targets areas linked to addiction. Studies show about 44 percent of people stop smoking right after treatment and 33 percent stay quit after six months. While rTMS has mostly been tested on cigarette smokers, it might help those using both cigarette types.

Pharmacogenetics helps pick medicines based on how people process nicotine. For instance, varenicline works best for people who digest nicotine normally, and nicotine patches work better for slow processors. Using this method for people who use both products might make treatment better and cut down on side effects.

Integrating Artificial Intelligence and Workflow Automation in Tobacco Cessation Services

Artificial intelligence (AI) and workflow automation are becoming important tools to improve quitting services in healthcare.

AI tools can analyze electronic health records to find patients at risk, including those who use both cigarettes and e-cigarettes. They can predict behavior, suggest personalized treatments, and alert healthcare providers about chances to help. For administrators and IT workers, AI makes it easier to find patients and offer help at the right time.

AI can also help with counseling and reaching out to patients. Automated phone systems can handle appointments, medication refills, and sending people to quitlines without needing more staff. This makes sure patients get quick and reliable help, helping them stick to quitting programs.

Workflow automation also helps schedule follow-ups, track patient progress through telehealth, and send reminders by text or app. Keeping contact over time is important, since more contact increases quitting success.

AI can screen for how strong addiction is by looking at complex data that doctors might miss during regular visits. This helps create better quitting plans that match each patient’s needs.

Using AI with healthcare technology helps connect mental health, primary care, and quitting services. This team approach is important for successful tobacco treatment.

Concluding Thoughts

Health clinics in the United States must adjust to the needs of people who use both cigarettes and e-cigarettes. This means using quitting programs that mix behavior therapies, medicines, digital tools, and special outreach to people who need extra help. Adding AI and automation tools makes these programs work better and reach more people.

By making systems that fit the specific difficulties of dual users and using new technology, health administrators, owners, and IT managers can play an important role in lowering tobacco use and improving health outcomes across the country.