Addictive tobacco use is the single greatest cause of disease and premature death in America today, responsible for more than 430,000 deaths annually. Smoked and smokeless tobacco intake have profound ill effects on oral tissues, especially those tissues associated with periodontal structures. This article describes the interactive aspects of addictive cigarette smoking and presents specific clinical and systems-based tobacco cessation interventions that can be utilized by health care providers. These programs offer a structured, multifaceted, and behavioral-based approach that includes the utilization of nicotine replacement therapy (NRT), monitoring and follow-up. The health care professional must consider all medical contraindications before using tobacco cessation medications.