title: Smoking cessation and the cardiovascular patient.
abstract: OBJECTIVE
  Smoking remains the leading cause of preventable morbidity and mortality. Our review highlights research from 2013 to 2015 on the treatment of cigarette smoking, with a focus on heart patients and cardiovascular outcomes.
  
  
  RESULTS
  Seeking to maximize the reach and effectiveness of existing cessation medications, current tobacco control research has demonstrated the safety and efficacy of combination treatment, extended use, reduce-to-quit strategies, and personalized approaches to treatment matching. Further, cytisine has gained interest as a lower-cost strategy for addressing the global tobacco epidemic. On the harm reduction front, snus and electronic nicotine delivery systems are being widely distributed and promoted with major gaps in knowledge of the safety of long-term and dual use. Quitlines, comparable in outcome to in-person treatment, make cessation counseling available on a national scale, though use rates remain relatively low. Employee reward programs are gaining attention given the high costs of tobacco use to employers; sustaining quit rates postpayment, however, has proven challenging.
  
  
  CONCLUSIONS
  Evidence-based cessation treatments exist. Broader dissemination, adoption, and implementation are key to addressing the tobacco epidemic. The cardiology team has a professional obligation to advance tobacco control efforts and can play an important role in achieving a smoke-free future.
authors.affiliation: aStanford Prevention Research Center, Department of Medicine, Stanford University, Stanford bDepartments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics, University of California, San Francisco, California, USA.
authors.forename: Judith J
authors.initials: JJ
authors.lastname: Prochaska
authors.forename: Neal L
authors.initials: NL
authors.lastname: Benowitz
mesh_terms: D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control / Q000523:psychology; D002319:Cardiovascular System / Q000187:drug effects; D040361:Healthy People Programs / Q000191:economics; D006801:Humans; D040242:Risk Reduction Behavior; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology / Q000628:therapy; D016540:Smoking Cessation / Q000191:economics / Q000379:methods / Q000523:psychology; D061485:Tobacco Use Cessation Devices; D014026:Nicotiana