Treating tobacco dependence in a medical setting

CA Cancer J Clin. Sep-Oct 2009;59(5):314-26. doi: 10.3322/caac.20031. Epub 2009 Aug 25.


The US Public Health Service Guideline for Treating Tobacco Use and Dependence 2008 Update emphasizes tobacco use as a chronic medical disorder; highlights both behavioral counseling and the use of 1 or more of the 7 approved medications; and points out the utility, efficacy, and reach of telephone quitlines. The treatment of users of smokeless tobacco continues to be less than optimal. Although providing evidence-based treatment for tobacco- dependent patients is a challenge for busy physicians, a team approach including trained and certified tobacco treatment specialists (TTS) provides an efficient treatment model. TTS represent a new and growing part of the health care team and hold great potential for expanding the collective tobacco treatment expertise in the medical setting. The effective treatment of tobacco dependence frequently requires tailoring, and often intensifying, interventions (both counseling and pharmacotherapy) to meet the needs of the individual patient.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Animals
  • Benzazepines / therapeutic use
  • Bupropion / therapeutic use
  • Cotinine / blood
  • Dopamine Uptake Inhibitors / therapeutic use
  • Humans
  • Nicotine* / administration & dosage
  • Practice Guidelines as Topic*
  • Quinoxalines / therapeutic use
  • Receptors, Nicotinic / drug effects
  • Smoking Cessation / methods
  • Tobacco Use Cessation / methods*
  • Tobacco Use Disorder / drug therapy*
  • Tobacco Use Disorder / physiopathology
  • Treatment Outcome
  • United States
  • United States Public Health Service
  • Varenicline


  • Benzazepines
  • Dopamine Uptake Inhibitors
  • Quinoxalines
  • Receptors, Nicotinic
  • Bupropion
  • Nicotine
  • Cotinine
  • Varenicline