Treating Tobacco Dependence in a Medical Setting


  • DISCLOSURES: Supported in part by Award Numbers R01 CA 12115 and R21 CA 132621 from the National Cancer Institute. Dr. Richard D. Hurt serves on the Advisory Board for Pfizer, Inc, and Dr. J. Taylor Hays has received a research grant from Pfizer, Inc. No other conflict of interest relevant to this article was reported. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health.

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The US Public Health Service Guideline for Treating Tobacco Use and Dependence 2008 Update emphasizes tobacco use as a chronic medical disorder; highlights both behavioral counseling and the use of 1 or more of the 7 approved medications; and points out the utility, efficacy, and reach of telephone quitlines. The treatment of users of smokeless tobacco continues to be less than optimal. Although providing evidence-based treatment for tobacco- dependent patients is a challenge for busy physicians, a team approach including trained and certified tobacco treatment specialists (TTS) provides an efficient treatment model. TTS represent a new and growing part of the health care team and hold great potential for expanding the collective tobacco treatment expertise in the medical setting. The effective treatment of tobacco dependence frequently requires tailoring, and often intensifying, interventions (both counseling and pharmacotherapy) to meet the needs of the individual patient. CA Cancer J Clin 2009;59:314–326. © 2009 American Cancer Society, Inc.