Treatment of Tobacco Use and Dependence

• Published in: The New England journal of medicine Vol. 346; no. 7; pp. 506 - 512
• Main Author: Rigotti, Nancy A
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 14-02-2002
• Subjects: Biological and medical sciences; Disease; General populations; Medical sciences; Nicotine; Prevention and actions; Public health. Hygiene; Public health. Hygiene-occupational medicine; Smoking cessation; United States > US; Human; Prognosis; Cardiovascular disease; Pharmacology; Weight; Quality of life; Case study; Symptomatology; Alkaloid; Tobacco; Treatment; Dependence; Profit; Public health; Nicotine
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMcp012279

A 66-year-old woman with stable angina and a history of depression smokes 25 cigarettes daily. She would like to stop smoking but is concerned about weight gain. She has made several unsuccessful attempts at quitting on her own. How should she be treated?
Foreword
This
Journal
feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations.
Stage
A 66-year-old woman with stable angina and a history of depression smokes 25 cigarettes daily. She would like to stop smoking but is concerned about weight gain. She has tried to quit several times on her own without success. What should her physician recommend?
The Clinical Problem
Tobacco use is the leading preventable cause of death in the United States, responsible for more than 400,000 deaths annually, or 1 of every 5 deaths.
1
Half of regular smokers die prematurely of a tobacco-related disease.
1
The potential health benefits of smoking cessation are substantial. Cessation reduces the risk of tobacco-related diseases, . . .