We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Grand Rounds | At the Northwestern University Feinberg School of Medicine| Clinician's Corner

Strategies to Help a Smoker Who Is Struggling to Quit

Nancy A. Rigotti, MD
JAMA. 2012;308(15):1573-1580. doi:10.1001/jama.2012.13043.
Text Size: A A A
Published online

Tobacco use is the leading preventable cause of death worldwide. Stopping tobacco use benefits virtually every smoker. Most of the 19% of US residents who smoke want to quit and have tried to do so. Most individual quit attempts fail, but two-thirds of smokers use no treatment when trying to quit. Treating tobacco dependence is one of the most cost-effective actions in health care. With a brief intervention, physicians can prompt smokers to attempt to quit and connect them to evidence-based treatment that includes pharmacotherapy and behavioral support (ie, counseling). Physicians can link smokers to effective counseling support offered by a free national network of telephone quit lines. Smokers who use nicotine replacement therapy (NRT), bupropion, or varenicline when trying to quit double their odds of success. The most effective way to use NRT is to combine the long-acting nicotine patch with a shorter-acting product (lozenge, gum, inhaler, or nasal spray) and extend treatment beyond 12 weeks. Observational studies have not confirmed case reports of behavior changes associated with varenicline and bupropion, and these drugs' benefits outweigh potential risks. A chronic disease management model is effective for treating tobacco dependence, which deserves as high a priority in health care systems as treating other chronic diseases like diabetes and hypertension.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?





You need to register in order to view this quiz.


Some tools below are only available to our subscribers or users with an online account.

38 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Related Multimedia

Author in the Room

audio player

Articles Related By Topic
Related Collections
PubMed Articles
Strategies to promote smoking cessation among adolescents. Paediatr Child Health 2016;21(4):201-8.
Smoking cessation for people with chronic obstructive pulmonary disease. Cochrane Database Syst Rev Published online Aug 20, 2016;

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Evidence to Support the Update

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Original Article: Is This Woman Perimenopausal?