Supplementary Material for: S3 Guideline “Smoking and Tobacco Dependence: Screening, Diagnosis, and Treatment” – Short Version

Introduction: In addition to the prevention of tobacco consumption, the establishment and assurance of high-quality treatment for harmful use and dependence on tobacco products remains an important health-related task in Germany. Regular updating of the Association of the Scientific Medical Societies (AWMF) S3 guideline “Smoking and Tobacco Dependence: Screening, Diagnosis, and Treatment” (Tobacco Guideline) offers a sustainable and reputable source of knowledge on smoking cessation. Methods: Under the auspices of the German Society for Psychiatry, Psychotherapy, Psychosomatics, and Neurology (DGPPN) and the German Society for Addiction Research and Addiction Therapy (DG-Sucht), the Tobacco Guideline was revised in 2019–2020 by 63 experts, who were involved in the development process of the text, in 11 working groups. Undue influence of conflicts of interest on the guideline could be minimized through careful conflict of interest management. Delegates from 50 professional societies discussed the 80 guideline recommendations and voted online. Results: In addition to recommendations for screening and diagnostics, the Tobacco Guideline takes a positive stance towards the use of low-threshold counseling and support services. If, due to the severity of the tobacco-related disorder, brief counseling, telephone counseling, or internet- or smartphone-based methods are not sufficiently effective, individual or group behavioral therapy, possibly in combination with medication, is indicated. If nicotine replacement therapy is not effective, varenicline or bupropion should be offered. Alternative strategies with a lower level of recommendation are hypnotherapy, mindfulness-based treatments, or medication with cytisine. In adolescents and pregnant women, the use of medication should be limited to well-specified exceptions and nicotine replacement. The mean agreement with the recommendations reached a value of 98%. A general overview of the treatment recommendations of the Tobacco Guideline is provided by three clinical algorithms.

引言：除烟草使用预防工作外，建立并保障针对烟草制品有害使用与依赖的高质量治疗，仍是德国卫生领域的重要任务之一。德国医学科学社团联合会（Association of the Scientific Medical Societies, AWMF）发布的S3级指南《吸烟与烟草依赖：筛查、诊断与治疗》（以下简称烟草指南）的定期更新，为戒烟领域提供了可持续且信誉卓著的知识来源。
方法：本指南由德国精神病学、心理治疗、心身医学与神经病学学会（German Society for Psychiatry, Psychotherapy, Psychosomatics, and Neurology, DGPPN）以及德国成瘾研究与成瘾治疗学会（German Society for Addiction Research and Addiction Therapy, DG-Sucht）牵头，由63名专家组成11个工作组，于2019-2020年完成修订，所有专家均参与了文稿的制定流程。通过严谨的利益冲突管理流程，可最大程度降低利益冲突对本指南的不当影响。来自50个专业社团的代表对80条指南推荐意见进行了讨论，并完成线上投票。
结果：除筛查与诊断相关推荐意见外，本指南对低门槛咨询与支持服务的应用持积极支持态度。若因烟草相关障碍的严重程度，导致简短咨询、电话咨询或互联网/智能手机相关干预手段效果不佳，则推荐采用个体或团体行为治疗，必要时联合药物治疗。若尼古丁替代疗法（nicotine replacement therapy）无效，则应提供伐尼克兰或安非他酮治疗。推荐等级较低的替代干预策略包括催眠治疗、正念疗法，或使用金雀花碱类药物。针对青少年与孕妇群体，药物治疗应严格限定在明确的例外情况，并仅可使用尼古丁替代疗法。代表对指南推荐意见的平均同意率达到98%。本指南通过3项临床算法，对戒烟治疗推荐意见进行了整体概览。