Smoking cessation: The most effective strategies

Effective smoking cessation strategies typically encompass the use of some pharmacotherapy with counseling by physicians. Patients who want to quit smoking should be given the Fagerstrom test to determine their degree of nicotine dependence. For low-nicotine-dependent smokers, the use of 1 smoking cessation product for a short period has proved successful; for high-dependence smokers, a combination of products, such as nicotine gum and nicotine patch, can be used. Other available smoking cessation products are the nicotine nasal spray, the nicotine inhaler, and sustained-release bupropion. Increasing the dose or duration of nicotine gum and patch has improved abstinence rates among high-dependence smokers. Quit rates have also been shown to increase with the dose of bupropion. Special consideration should be given before using pharmacotherapy in patients with medical contraindications, patients who are pregnant or breast-feeding, and adolescent smokers. For some patients, the cost of pharmacotherapy may be a barrier to quitting.