This Journal feature begins with a case vignette highlightinga common clinical problem. Evidence supporting various strategiesis then presented, followed by a review of formal guidelines,when they exist. The article ends with the author's clinicalrecommendations.
A 66-year-old woman with stable angina and a history of depressionsmokes 25 cigarettes daily. She would like to stop smoking butis concerned about weight gain. She has tried to quit severaltimes on her own without success. What should her physicianrecommend?
The Clinical Problem
Tobacco use is the leading preventable cause of death in theUnited States, responsible for more than 400,000 . . . [Full Text of this Article]
Strategies and Evidence
Interventions by Physicians
Counseling
Pharmacotherapy
Nicotine-Replacement Therapy
Non-Nicotine Therapy
Other Methods
Weight Gain after Smoking Cessation
Areas of Uncertainty
Guidelines
Conclusions and Recommendations
Source Information
From the Tobacco Research and Treatment Center, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston.
Address reprint requests to Dr. Rigotti at the Tobacco Research and Treatment Center, Massachusetts General Hospital, 50 Staniford St., 9th Fl., Boston, MA 02114, or at nrigotti@partners.org.
Grassi, M. C., Enea, D., Ferketich, A. K., Lu, B., Nencini, P.
(2009). A smoking ban in public places increases the efficacy of bupropion and counseling on cessation outcomes at 1 year. Nicotine Tob Res
11: 1114-1121
[Abstract][Full Text]
Katz, M. H.
(2009). Structural Interventions for Addressing Chronic Health Problems. JAMA
302: 683-685
[Full Text]
Dozier, A. M., Ossip, D. J., Diaz, S., Sierra-Torres, E., Quinones de Monegro, Z., Armstrong, L., Chin, N. P., McIntosh, S.
(2009). Health Care Workers in the Dominican Republic: Self-Perceived Role in Smoking Cessation. Eval Health Prof
32: 144-164
[Abstract]
Wein, R. O.
(2009). Preoperative Smoking Cessation: Impact on Perioperative and Long-term Complications. Arch Otolaryngol Head Neck Surg
135: 597-601
[Full Text]
Simon, J. A., Duncan, C., Huggins, J., Solkowitz, S., Carmody, T. P.
(2009). Sustained-release bupropion for hospital-based smoking cessation: A randomized trial. Nicotine Tob Res
11: 663-669
[Abstract][Full Text]
Moss, D. R., Cluss, P. A., Watt-Morse, M., Pike, F.
(2009). Targeting pregnant and parental smokers: Long-term outcomes of a practice-based intervention. Nicotine Tob Res
0: ntn035v2-ntn035
[Abstract][Full Text]
Ischaki, E., Gratziou, C.
(2009). Smoking and depression: is smoking cessation effective?. Ther Adv Respir Dis
3: 31-38
[Abstract]
Cornuz, J., Willi, C.
(2008). Nonpharmacological smoking cessation interventions in clinical practice. ERR
17: 187-191
[Abstract][Full Text]
Chiolero, A., Faeh, D., Paccaud, F., Cornuz, J.
(2008). Consequences of smoking for body weight, body fat distribution, and insulin resistance. Am. J. Clin. Nutr.
87: 801-809
[Abstract][Full Text]
Steinberg, M. B., Schmelzer, A. C., Richardson, D. L., Foulds, J.
(2008). The Case for Treating Tobacco Dependence as a Chronic Disease. ANN INTERN MED
148: 554-556
[Abstract][Full Text]
Reddy, R C
(2008). Severe asthma: approach and management. Postgrad. Med. J.
84: 115-120
[Abstract][Full Text]
Le Foll, B. MD PhD, George, T. P. MD
(2007). Treatment of tobacco dependence: integrating recent progress into practice. CMAJ
177: 1373-1380
[Abstract][Full Text]
Fossati, R., Apolone, G., Negri, E., Compagnoni, A., La Vecchia, C., Mangano, S., Clivio, L., Garattini, S., for the General Practice Tobacco Cessation Investi,
(2007). A Double-blind, Placebo-Controlled, Randomized Trial of Bupropion for Smoking Cessation in Primary Care. Arch Intern Med
167: 1791-1797
[Abstract][Full Text]
Torrijos, R. M, Glantz, S. A
(2006). The US Public Health Service "treating tobacco use and dependence clinical practice guidelines" as a legal standard of care. Tobacco Control
15: 447-451
[Abstract][Full Text]
Strayer, S. M., Rollins, L. K., Martindale, J. R.
(2006). A handheld computer smoking intervention tool and its effects on physician smoking cessation counseling.. J Am Board Fam Med
19: 350-357
[Abstract][Full Text]
Ford, S. K., Shilliday, B. B.
(2006). Smoking and Diabetes: Helping Patients Quit. Clin. Diabetes
24: 133-137
[Full Text]
Ward, K D, Eissenberg, T, Rastam, S, Asfar, T, Mzayek, F, Fouad, M F, Hammal, F, Mock, J, Maziak, W
(2006). The tobacco epidemic in Syria. Tobacco Control
15: i24-i29
[Abstract][Full Text]
Pickering, T. G.
(2006). New Guidelines on Diet and Blood Pressure. Hypertension
47: 135-136
[Full Text]
Scholte op Reimer, W., de Swart, E., De Bacquer, D., Pyorala, K., Keil, U., Heidrich, J., Deckers, J. W., Kotseva, K., Wood, D., Boersma, E., for the EUROASPIRE Investigators,
(2006). Smoking behaviour in European patients with established coronary heart disease. Eur Heart J
27: 35-41
[Abstract][Full Text]
Liew, Y. P., Bartholomew, J. R
(2005). Atheromatous embolization. Vasc Med
10: 309-326
[Abstract]
Ashen, M. D., Blumenthal, R. S.
(2005). Low HDL Cholesterol Levels. NEJM
353: 1252-1260
[Full Text]
McFall, M., Saxon, A. J., Thompson, C. E., Yoshimoto, D., Malte, C., Straits-Troster, K., Kanter, E., Zhou, X.-H. A., Dougherty, C. M., Steele, B.
(2005). Improving the Rates of Quitting Smoking for Veterans With Posttraumatic Stress Disorder. Am. J. Psychiatry
162: 1311-1319
[Abstract][Full Text]
Frieden, T. R., Mostashari, F., Kerker, B. D., Miller, N., Hajat, A., Frankel, M.
(2005). Adult Tobacco Use Levels After Intensive Tobacco Control Measures: New York City, 2002-2003. AJPH
95: 1016-1023
[Abstract][Full Text]
Montalto, N. J., Ferry, L. H., Stanhiser, T.
(2004). Tobacco Dependence Curricula in Undergraduate Osteopathic Medical Education. JAOA: Journal of the American Osteopathic Association
104: 317-323
[Abstract][Full Text]
Schroeder, S. A.
(2004). Tobacco Control in the Wake of the 1998 Master Settlement Agreement. NEJM
350: 293-301
[Full Text]
Rigotti, N. A
(2003). Putting the research into practice. BMJ
327: 1395-1396
[Full Text]
Himelhoch, S., Daumit, G.
(2003). To Whom Do Psychiatrists Offer Smoking-Cessation Counseling?. Am. J. Psychiatry
160: 2228-2230
[Abstract][Full Text]
Winickoff, J. P., Buckley, V. J., Palfrey, J. S., Perrin, J. M., Rigotti, N. A.
(2003). Intervention With Parental Smokers in an Outpatient Pediatric Clinic Using Counseling and Nicotine Replacement. Pediatrics
112: 1127-1133
[Abstract][Full Text]
Pbert, L., Moolchan, E. T., Muramoto, M., Winickoff, J. P., Curry, S., Lando, H., Ossip-Klein, D., Prokhorov, A. V., DiFranza, J., Klein, J. D.
(2003). The State of Office-Based Interventions for Youth Tobacco Use. Pediatrics
111: e650-660
[Abstract][Full Text]
Jain, A, Wadehra, V, Timmis, A D
(2003). Management of stable angina. Postgrad. Med. J.
79: 332-336
[Abstract][Full Text]
Lenert, L., Munoz, R. F., Stoddard, J., Delucchi, K., Bansod, A., Skoczen, S., Perez-Stable, E. J.
(2003). Design and Pilot Evaluation of an Internet Smoking Cessation Program. J. Am. Med. Inform. Assoc.
10: 16-20
[Abstract][Full Text]
Williams, G. C.
(2002). Response to Connelly: First at the Gates of Fire: can there be any survivors?. Health Educ Res
17: 700-703
[Full Text]
Lippman, S. M., Hong, W. K.
(2002). Cancer Prevention Science and Practice. Cancer Res.
62: 5119-5125
[Full Text]
Rieves, D.
(2002). Suffer the Children. Chest
122: 394-396
[Full Text]
Butler, C. C., Rollnick, S., Gatt, M. E., Heyman, S. N., Rigotti, N.
(2002). Treatment of Tobacco Use and Dependence. NEJM
347: 294-295
[Full Text]