Emergency Department Management of Nicotine Use: A White Paper Prepared for the American Academy of Emergency Medicine.

BACKGROUND: Tobacco and other nicotine use remains a major public health concern, and Emergency Physicians commonly evaluate and treat patients with nicotine use disorder (NUD). However, it unfortunately remains largely untreated or undertreated in the Emergency Department setting. OBJECTIVES: To provide expert guidance for the safe and effective treatment of NUD from the Emergency Department setting. METHODS: Independent literature searches were performed regarding nicotine use. A panel of experts in Addiction Medicine, Toxicology, and Emergency Medicine reviewed and discussed the literature to develop expert consensus guidance. RESULTS: This paper discusses the available evidence and provides recommendations for the screening and treatment of NUD in the acute care setting. CONCLUSIONS: Emergency physicians have an important opportunity to meaningfully reduce morbidity and mortality for patients with NUD by starting safe and evidence-based NUD treatments. We recommend that all patients with NUD presenting to the acute care setting be offered medications for NUD as well as brief counseling on NUD, and be referred to local outpatient follow up or other available resources for continued NUD care on discharge.