title: Smoking cessation intervention: an evidence-based approach.
abstract: Cigarette smoking represents the most important source of preventable morbidity and premature mortality worldwide. Approximately 100 million deaths were caused by tobacco use in the 20th century. There are >1 billion smokers worldwide, and globally the use of tobacco products is increasing, with the epidemic shifting to the developing world. Tobacco dependence is a chronic condition that often requires repeated intervention for success. Just informing a patient about health risks, although necessary, is usually not sufficient for a decision to change. Smokers should be provided with counseling when attempting to quit. Pharmacologic smoking cessation aids are recommended for all smokers who are trying to quit, unless contraindicated. Evidence-based guidelines recommend nicotine replacement therapy, bupropion SR, and varenicline as effective alternatives for smoking cessation therapy, especially when combined with behavioral interventions. Combination pharmacotherapy is indicated for highly nicotine-dependent smokers, patients who have failed with monotherapy, and patients with breakthrough cravings. An additional form of nicotine replacement therapy or an addition of a non-nicotine replacement therapy oral medication (bupropion or varenicline) may be helpful. The rate of successful smoking cessation at 1 year is 3% to 5% when the patient simply tries to stop, 7% to 16% if the smoker undergoes behavioral intervention, and up to 24% when receiving pharmacological treatment and behavioral support.
authors.affiliation: Facultad de Medicina Tijuana, Universidad Autónoma de Baja California. rafaellaniado@gmail.com
authors.forename: Rafael
authors.initials: R
authors.lastname: Laniado-Laborín
mesh_terms: D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D001521:Behavior Therapy; D001552:Benzazepines / Q000627:therapeutic use; D016642:Bupropion / Q000627:therapeutic use; D037001:Directive Counseling; D004359:Drug Therapy, Combination; D019317:Evidence-Based Medicine; D014943:Global Health; D006801:Humans; D009538:Nicotine / Q000008:administration & dosage; D018722:Nicotinic Agonists / Q000627:therapeutic use; D011810:Quinoxalines / Q000627:therapeutic use; D012907:Smoking / Q000009:adverse effects / Q000188:drug therapy / Q000628:therapy; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D000068580:Varenicline
chemical_list: D018687:Antidepressive Agents, Second-Generation; D001552:Benzazepines; D018722:Nicotinic Agonists; D011810:Quinoxalines; D016642:Bupropion; D009538:Nicotine; D000068580:Varenicline