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Last Updated: 9/26/2013  

Smoking Cessation

  • Routinely query all patients about their current smoking status.

  • Ask all smokers about their willingness to quit, as smoking cessation is associated with a reduction in all-cause mortality, atherosclerotic disease, obstructive lung disease, and some malignancies.

  • Encourage smoking cessation strongly in patients with coronary artery disease or obstructive lung disease; patients with established coronary artery disease who quit smoking have a large reduction in risk for death compared with patients who continue.

  • Provide all smokers with a brief counseling intervention to encourage smoking cessation.

  • Recognize that bupropion, nicotine replacement therapy, varenicline, and behavioral counseling all have been shown to be effective aids in smoking cessation and should be offered to all smokers who are interested in quitting.

  • Encourage smoking cessation before and during pregnancy because cessation reduces the incidence of both preterm labor and low-birth-weight infants.

  • Recognize that individuals with established obstructive lung disease who are counseled to quit smoking have a slower deterioration of lung function than patients who continue to smoke.

  • Focus smoking-cessation efforts on individuals with children because environmental tobacco smoke increases the development of respiratory disease in children.

DOI: 10.7326/prev374
The information included herein should never be used as a substitute for clinical judgment and does not represent an official position of ACP.
Disclosures:
Kumanan Wilson, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Shadi Nahvi, MD, MS has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
The following editors of ACP Smart Medicine have nothing to disclose: Deborah Korenstein, MD, FACP, Editor in Chief; Richard B. Lynn, MD, FACP, Editor; and Davoren Chick, MD, Editor.
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