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Abigail Brooks is an assistant editor for 

She joined MJH Life Sciences in August 2023 shortly after graduating from Monmouth University where she earned her BA in Communication with a concentration in Public Relations/Journalism and later an MA in Interactive Digital Media. She enjoys traveling, running, and reading books. She can be reached at abrooks@mjhlifesciences.com.

The Centers for Disease Control and Prevention cites tobacco use as the leading cause of preventable disease, disability, and death in the United States, with 2021 data suggesting about 28.3 million US adults smoke cigarettes and more than 16 million people live with at least one disease caused by smoking.

Like other chronic diseases, tobacco dependence is a relapsing disorder frequently requiring repeated intervention and long-term support. Thus, many patients struggling to quit rely on support from health care providers, a topic discussed by Hasmeena Kathuria, MD, associate professor of medicine at Boston University School of Medicine and director of the Tobacco Treatment Center at Boston Medical Center, in a session at the 

2024 American College of Physicians (ACP) Internal Medicine Meeting

 editorial team, Kathuria discussed the current state of smoking cessation in the US, behavioral approaches to reduce tobacco dependence, and other key takeaways from her presentation at the conference.

Can you tell me a little bit about the current state of tobacco cessation programs and what we know about their benefit for promoting health behavior change?

: So getting people to stop smoking is the greatest health benefit there is. So that really needs to be a priority in all clinical encounters and state programs. We know that if people stop smoking at any age, there's benefits. If we can get people to stop smoking before the age of 35, their mortality is the same as somebody who's never smoked. But even if we can get people to stop at greater than 65, there continues to be that benefit.

Looking at these programs, what do we know about what makes them successful?

: Successful programs are ones where clinicians bring up that topic. We know that electronic health record approaches, for instance, where you're screening everyone for tobacco use for cigarettes, and really all tobacco products, are the first place to start, and then treating tobacco use disorder as a chronic disease. Traditionally, we offer treatment for people who say that they're ready to set a quit date in 30 days. But we know that only 70% to 80% of people are ready to set a quit date. So if we offer treatment to all people, similar to diabetes and high blood pressure, we don't say ‘Do you want to be treated for your diabetes?’ We discuss with patients how best to treat patients for diabetes. So I think those are things that are really important, to screen everybody and to offer tobacco treatment to everybody who smokes, regardless of clinical condition, and regardless of their readiness to stop smoking.

Looking at it from a behavioral standpoint, what changes should be encouraged to decrease tobacco dependence?

: I think the most important thing is when we talk to patients, we use non-stigmatizing language. People who smoke want to smoke, and it's just a very powerful addiction. Many times patients will tell me ‘Well, you know, you probably think that I did this to myself’ and we want to make sure that we when we talk to people, we understand where they're coming from. With behavioral approaches it really depends on where they are in their readiness to quit. So if somebody is ready to stop smoking, offering treatment, which includes counseling and medications, but even if patients aren't ready to quit, to kind of get them to that point, asking ‘Are you willing to take a medication that may help you quit one day?’ rather than absolutely making people say that they need to stop right now.

Beyond behavioral changes, what are some of the pharmacologic treatment options for tobacco dependence?

: There are 7 FDA-approved medications. There's several studies that show a varenicline is more effective than the other medications that we have, particularly studies that have compared varenicline to nicotine patch or varenicline to bupropion. So, that's our first medication that we recommend, but some people don't want medications and prefer that instead of the pill form, they want the nicotine patch or nicotine gum or lozenge. Usually our first line is varenicline or combination nicotine replacement therapy.

Despite our best efforts, what issues still remain when it comes to tobacco dependence and shortcomings to reduce it and where do you see more work that needs to be done?

: When you look at tobacco dependence in the 1960s, about 50% of the US population smoked cigarettes, and now it's about 12% to 13%. But really, when you take a deeper dive into who's smoking, it's people who are socio-economically disadvantaged, so people who experience mental health disease, people who experience homelessness, people who have other substance use disorders. For instance, people who use who have opioid use disorder, they smoke at rates as high as 80% to 90%, so that's something that we really need to understand. Black people, their patterns of smoking are different. Instead of daily smoking, they smoke intermittently, they smoke fewer cigarettes a day, yet they die from tobacco-related disease at a much higher level than White people, and so making sure that we are including all people who smoke and who smoke intermittently, who smoke fewer cigarettes, that's really important. And then, of course, the concern with youth and adolescents and vaping and other products, so really to try to do more studies on getting effective treatment for other nicotine products is important.”

This transcript has been edited for clarity.

1. US Centers for Disease Control and Prevention. Data and Statistics. Smoking & Tobacco Use. November 2, 2023. Accessed April 20, 2021. 

https://www.cdc.gov/tobacco/data_statistics/index.htm

Articles

In this Q&A, Kathuria explains the current state of smoking cessation programs and how health care providers can help patients combat their tobacco dependence.

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Approaches to Promote Health Behavior Change and Smoking Cessation, with Hasmeena Kathuria, MD

Tim Smith joined the MJH Life Sciences team as an assistant editor for HCPLive in August 2022. He graduated from UC Berkeley with a degree in political science, working in multimedia journalism as a staff writer prior to joining MJH. In his spare time, he enjoys reading, watching TV, listening to podcasts, and rock climbing. You can contact him at 

During this segment of her interview at the ACP Internal Medicine Meeting, Jay discussed improving obesity care, telehealth utilization for patients, and more.

Discussing Ways to Approach Improving Obesity Care with Melanie Jay, MD

In this interview segment, Melanie Jay, MD, MS, general internist and associate professor at NYU Langone Health, spoke on additional takeaways from her conference presentation on advancing equity in obesity care, given at the 

Jay, who is board-certified in obesity medicine, spoke with the 

 editorial team about several different topics connected to obesity. First, Jay was asked whether her talk covered glucagon-like peptide-1 receptor agonists (GLP-1-RAs) such as Ozempic as a topic of interest.

“We didn't go into the different GLP-1-receptor agonists that are so popular like semaglutide and tirzepatide,” Jay said. “We had one question about whether we can think about obesity like addiction and what the overlaps are. So then I did a little discussion about how in the brain, we have both homeostatic mechanisms that regulate how hungry we are, and how much we're eating and our metabolism. Then there's hedonic mechanisms, as well, that are pleasure centers. The GLP-1s, I think, work on both.”

Jay noted the importance and necessity of additional research on such a topic, adding the unique finding that there had been evidence suggesting GLP-1 receptor agonists led to fewer cravings for alcohol among users.

Later, Jay was asked about the role she sees technology playing in the future of obesity care, especially in terms of personalized treatment plans and patient engagement.

“I think telehealth, for instance, since-COVID has blossomed everywhere,” Jay said. “And weight management, because we want to check in a lot with our patients and follow them to make it convenient for people, making it so that follow up care can really be delivered in telehealth. It always is good to examine our patients the first time, but in follow up, we can check in with them via telehealth and they don't have to leave their jobs or get child care to come in and get adequate care.”

Jay also noted that patient-generated health data’s best integration is still being researched, adding that it is important to figure out the interface likely to make it so that there is not an increased workload but engagement is improved.

The quotes contained in this discussion were edited for the purposes of clarity. Jay had no relevant disclosures.


Videos

Internal Medicine

Internal Medicine condition center page, resources on the topics of medical news and expert insight into internal medicine can be found. Content includes articles, interviews, videos, podcasts, and breaking news on internal medicine research, treatment, and drug development.

Diabetes Dialogue: 2024 ACP Type 2 Recommendations

A reflection of the growing evidence base supporting the safety and efficacy of these classes in management of 

 and related comorbidities, the American College of Physicians has released new recommendations in favor of SGLT2 inhibitors and GLP-1 receptor agonists and against use of DPP-4 inhibitors as second-line therapies to metformin in adults with type 2 diabetes and inadequate glycemic control.

“As additional pharmacological treatments become available for the treatment of Type 2 diabetes, it’s critical for us to examine their effectiveness, the harms and benefits as well as costs in order to provide the best treatment for our patients,” said Carolyn J. Crandall, MD, MS, an internal medicine physician at the University of California Los Angeles School of Medicine and the chair of the Guidelines Committee.

, the pair of recommendations reflect the findings from a systematic review and network meta-analysis and cost-effectiveness analysis assessing the value of these therapies as both monotherapies and in combination with metformin. Of note, the recommendations do not consider the effects of each class on glycemic parameters.

The recommendations from the ACP are as follows:

Recommendation 1: Add an SGLT2 inhibitor or GLP-1 receptor agonist to metformin and lifestyle modifications in adults with type 2 diabetes and inadequate glycemic control (strong recommendation; high-certainty evidence).

Use an SGLT2 inhibitor to reduce the risk for all-cause mortality, major adverse cardiovascular events, progression of chronic kidney disease, and hospitalization due to congestive heart failure.

Use a GLP-1 agonist to reduce the risk for all-cause mortality, major adverse cardiovascular events, and stroke.

Recommendation 2: Against adding a DPP-4 inhibitor to metformin and lifestyle modifications in adults with type 2 diabetes and inadequate glycemic control to reduce morbidity and all-cause mortality (strong recommendation; high-certainty evidence).

Attendees at this year’s Internal Medicine Meeting, Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, discuss the ACP’s latest recommendations in a special ACP 2024 edition of 

Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives

Relevant disclosures for Dr. Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Dr. Bellini include Abbott Diabetes Care, MannKind, Sanofi, and others.

Qaseem A, Obley AJ, Shamliyan T, Hicks LA, Harrod CS, Crandall CJ. Newer pharmacologic treatments in adults with type 2 diabetes: A clinical guideline from the American College of Physicians. 

. Published online April 19, 2024. doi:10.7326/m23-2788

American College of Physicians. ACP issues clinical recommendations for newer pharmacological treatments of adults with type 2 diabetes. ACP issues clinical recommendations for newer pharmacological treatments of adults with Type 2 diabetes | ACP Online. April 19, 2024. Accessed April 19, 2024. https://www.acponline.org/acp-newsroom/acp-issues-clinical-recommendations-for-newer-pharmacological-treatments-of-adults-with-type-2.

Podcasts

In this episode, hosts break down the latest type 2 diabetes recommendations from the American College of Physicians and offer their perspective on second-line therapies in T2D.

Type 2 Diabetes

Endocrinology

The HCPLive endocrinology page is a comprehensive resource for clinical news and insights on endocrine system conditions. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for diabetes, hormonal disease, and more.

Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives is a monthly podcast hosted by Diana Isaacs, PharmD, and Natalie Bellini, DNP, aimed at providing a regular roundup of the latest clinically applicable insights across diabetes and metabolic diseases, with a focus on leveraging technology to improve care.

Diabetes Dialogue: 2024 ACP Type 2 Diabetes Recommendations

Worldwide, the health care industry contributes approximately 5% of total greenhouse gas emissions and similar fractions of toxic air emissions, coming primarily from the US health care sector and contributing directly to the climate change crisis.

In line with health care’s notable contributions to climate change, the health care system also feels the impact of changing climatic conditions, something Elizabeth Cerceo, MD, associate internal medicine program director and director of environmental health in the division of hospital medicine at Cooper University Health Care, discussed in her session at the 

“Just in our practice of medicine, we see the waste, we see that there's unnecessary care. And that all translates into not only expense, but also waste in landfills, plastic waste, energy usage, it's all of these things that contribute to the downstream adverse effects on our environment, which can then indirectly harm our patients,” Cerceo explained in an interview with 

“That's not what we're aiming to do, we want to take care of our patients.”

Cerceo explains how the health care system contributes to climate change and the subsequent negative impact on patients, especially in vulnerable communities.

Health Care’s Contribution to Climate Change, with Elizabeth Cerceo, MD

She went on to describe how she sees climate health in 2 streams: medicine’s impact on healthcare sustainability and recognizing climate change’s impact on patients. Specifically, she cited people who live near incinerators or who spend time sitting in traffic and the impact such exposures can have on conditions health care providers treat every day, like diabetes, hypertension, and heart disease.

“We really need to increasingly understand that the ecological determinants of health are even more foundational, and they're affecting our patients, and us, everyone, all the time,” Cerceo emphasized, noting most people don’t make the connection between these health issues and their linkage to environmental factors.

She also made a point of highlighting the disproportionate impact on certain communities, describing “people who may live near fracking, who live near incinerators, who live within 100-200 feet of highways and are exposed to ultra-fine particulate matter and pollution all the time, these vulnerable, disadvantaged communities are going to be disproportionately harmed from climate impacts.”

Eckelman MJ, Huang K, Lagasse R, et al. Health Care Pollution And Public Health Damage In The United States: An Update. Health Affairs. https://doi.org/10.1377/hlthaff.2020.01247

Cerceo explains how the health care system contributes to climate change and the subsequent negative impact on patients, especially those in vulnerable or disadvantaged communities.

This interview segment featured a discussion on Jay’s ACP Internal Medicine Meeting presentation ‘Advancing Equitable Approaches to Improve Obesity Care.’

Melanie Jay, MD: Advancing Equitable Approaches to Improve Obesity Care

During recent years, it is evident that there has been a shift among health care providers towards understanding the value of equitable approaches in obesity care. This shift reflects a growing awareness of the various types of factors impacting weight management and the necessity for tailored strategies to address such a complex issue.

In this interview segment with Melanie Jay, MD, MS, the editorial team at 

 spoke with Jay regarding her presentation at the 

2024 American College of Physicians Internal Medicine Meeting

 titled ‘Advancing Equitable Approaches to Improve Obesity Care.’ Jay is a general internist and is board-certified in obesity medicine, serving as an associate professor for NYU Langone Health.

“This was a topic that's near and dear to my heart, addressing health equity and health disparities,” Jay explained. “At the intro, we discussed what happened at that session and then I introduced the concept of disparities in obesity care, disparities, health disparities around obesity. Then we also talked about different strategies to address health disparities and health equity and obesity, and really touched on four or five major areas, one of them being to really address obesity stigma.”

Jay noted that obesity is a stigmatized condition, adding that over 40% of people with class 2 and class 3 obesity say that they have experienced weight discrimination. Jay added that patients say that they have experienced obesity-related discrimination and bias even in health care settings.

“So we talk about how we can provide more compassionate care, not blame the patient, and recognize that obesity is a disease and that it is a chronic disease,” Jay said. “It's an interplay between our genes and our environment. Personal choices, while important, play a very small role. Things like our food environment, stress levels, our physical activity opportunities, and medications we give our patients can cause weight gain.”

Jay explained that when a patient enters the office and they feel blamed, this can impact feelings of stigma. She also noted the importance of advocacy.

“As physicians, we have a lot of opportunities to really advocate for our patients,” she said. “So we can advocate for policies such as Medicaid expansion of obesity care, such as Medicare expansion, as well. There are federal policies right now with the Treat and Reduce Obesity Act. We can locally make sure that our residents and our medical students get adequate training to be able to compassionately and proficiently address obesity. Then we can make sure that we provide interdisciplinary care and that we work with each other.

Jay explained that she believes it is important to engage with patients, adding that research in the space is also essential.

 interview segment, view the video posted above.

The quotes contained in this discussion were edited for the purposes of clarity. Jay had no relevant disclosures.

This interview segment featured a discussion on Jay’s ACP Internal Medicine Meeting presentation ‘Advancing Equitable Approaches to Improve Obesity Care.’


Lopez discusses the growing prevalence of obesity in the US and the need for improved, cross-specialty care based on patients’ metabolic health.

Obesity Management

Obesity Management condition center page, resources on the topics of medical news and expert insight into clinical weight management can be found. Content includes articles, interviews, videos, podcasts, and breaking news on obesity research, treatment, and drug development.

Ana Maria Lopez, MD, MPH: The Current State of Obesity Care is ‘Woefully Deficient’

Wilt discusses ACP guidelines regarding what age to begin colorectal cancer screening and the benefits versus harms of screening at 45 compared to 50 years of age.

Gastroenterology

Gastroenterology condition center page is a comprehensive resource for clinical news and insights on digestive and GI conditions. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for 

, IBS and IBD, Crohn's disease, and more.

Timothy Wilt, MD, MPH: What Age Should Patients Get Screened for Colorectal Cancer?

Patrick Campbell is the managing editor of HCPLive. Formerly the editorial lead of Endocrinology Network, Practical Cardiology, and Rheumatology Network, Patrick has spent years spearheading coverage surrounding cardiometabolic health and rheumatic disease for MJH Life Sciences. He now helps to lead coverage in each of these respective areas for HCPLive. Before joining MJH Life Sciences in 2019, he spent time as a beat reporter with the Pocono Record in Stroudsburg, PA, and Star News Group in Manasquan, NJ. He also touts experience in multimedia, having spent time as a multimedia specialist with NJ Advance Media and multimedia coordinator at the Pocono Record. Follow him on Twitter @RealPatCampbell or reach him via email at PCampbell@mjhlifesciences.com.

The American College of Physicians released new recommendations for the management of type 2 diabetes with inadequate glycemic control using metformin or other first-line therapies. 

Cardiology

Cardiology condition center page is a comprehensive resource for clinical news and insights on cardiovascular and cardiometabolic diseases. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for heart disease and cardiovascular events, as well as associated diabetes, renal failure, and more...

Nephrology

The HCPLive nephrology page is a resource for medical news and expert insights on kidney disease. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments in nephrology, and more.

ACP's New Type 2 Diabetes Guidance Recommends SGLT2is, GLP-1 RAs as Second-Line to Metformin

Silas Inman joined MJH Life Sciences® in early 2011 as one of the company's first web editors, on the website OncLive.com. Throughout his tenure at MJH, Silas has been accountable for several organic launches of highly successful brands, including Targeted Oncology™ and NeurologyLive®, and for quickly transforming acquisitions into high-functioning business units. In 2014, he integrated CURE® Media Group into the MJH portfolio, quickly growing the online traffic, launching new offerings, and streamlining the brand’s print strategy. He continued this trend in 2019 with the acquisition of the UBM Life Sciences brands, which includes brands such as Medical Economics®.

Large language model AI tools like ChatGPT quickly, easily, and effectively modified dense medical information into grade 6 to 8 reading levels. 

ChatGPT Effectively Modifies Medical Notes to Patient-Friendly Formats

This ACP Conference interview featured a discussion with Inouye about gaps in knowledge regarding patients experiencing delirium during hospitalization.

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Sharon K. Inouye, MD, MPH: Why is Delirium During Hospitalization Not Taken Seriously?

Experts discuss the warnings regarding IL-17 blockers and inflammatory bowel disease.

Peer Exchange

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Inflammatory Bowel Disease

On the HCPLive inflammatory bowel disease page, resources on the topics of medical news and expert insight into IBD can be found. Content includes articles, interviews, videos, podcasts, and breaking news on IBD and more.

Understanding Biologics for Patients With IBD

Experts emphasize the importance of collaboration with infectious disease specialists for patients with tuberculosis, while highlighting the low reactivation rates in newer agents.

Plaque Psoriasis

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Dermatology

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Infectious Diseases and Biologic Treatment Selection

TJ Chao and Kristine Kucera, PA’s discuss the changing treatment algorithms of plaque psoriasis with the arrival of novel agents such as the TYK2 inhibitors. 

Ophthalmology

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Impact of the Expanding Treatment Landscape on the Treatment Algorithm of Plaque Psoriasis

Providers in rheumatology, dermatology and gastrointestinal disease talk about how they are selecting between the various adalimumab biosimilars available for their patients.

Biosimilars

Selecting Between Adalimumab Biosimilars for Your Patients

In recognition of World IBS Day, we spoke with Jeffrey Roberts about what led him to found the holiday in 2019 and took a closer look at the continued marginalization of the condition.

Irritable Bowel Syndrome

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Latest News

Approaches to Promote Health Behavior Change and Smoking Cessation, with Hasmeena Kathuria, MD

Discussing Ways to Approach Improving Obesity Care with Melanie Jay, MD

Diabetes Dialogue: 2024 ACP Type 2 Diabetes Recommendations

Health Care’s Contribution to Climate Change, with Elizabeth Cerceo, MD

Melanie Jay, MD: Advancing Equitable Approaches to Improve Obesity Care