title: [Helping the "hard-core" smokers].
abstract: Smoking cessation specialists are frequently confronted with smokers who have great difficulty in stopping smoking, and who are either motivated to stop or are forced to stop for health, economic or statutory reasons. These smokers are composed of a mixed population but they have in common a heavy dependence on tobacco and a significant level of cigarette consumption. They are exposed to serious morbidity induced by their uncontrollable smoking. Other factors unfavourable to the attempt to stop smoking are often present: anxiety-depressive disorders, socioeconomic difficulties or the use of psychoactive substances. They constitute a priority target for smoking cessation clinics, which must optimise and diversify proposals to improve their interventions. This review describes these highly dependent smokers unable to stop, and suggests medical treatments and therapeutic combinations to assist the practitioners trying to help the "hard-core" smokers.
authors.affiliation: Dispensaire Émile-Roux, centre de lutte antituberculeux (CLAT 63), centre de tabacologie, 11 rue Vaucanson, Clermont-Ferrand, France. jean.perriot@cg63.fr
authors.forename: J
authors.initials: J
authors.lastname: Perriot
authors.forename: M
authors.initials: M
authors.lastname: Underner
authors.forename: G
authors.initials: G
authors.lastname: Peiffer
authors.forename: J
authors.initials: J
authors.lastname: Le Houezec
authors.forename: L
authors.initials: L
authors.lastname: Samalin
authors.forename: A
authors.initials: A
authors.lastname: Schmitt
authors.forename: I
authors.initials: I
authors.lastname: de Chazeron
authors.forename: L
authors.initials: L
authors.lastname: Doly-Kuchcik
mesh_terms: D000465:Algorithms; D006379:Helping Behavior; D006801:Humans; D009042:Motivation / Q000502:physiology; D009538:Nicotine / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D012907:Smoking / Q000453:epidemiology / Q000235:genetics / Q000628:therapy*; D016540:Smoking Cessation / Q000379:methods*; D014029:Tobacco Use Disorder / Q000453:epidemiology / Q000209:etiology / Q000235:genetics / Q000628:therapy
chemical_list: D009538:Nicotine