Smoking Cessation

Smoking Cessation

Tobacco use is the leading cause of preventable illness and death in the United States. It

causes numerous cancers, heart disease, stroke, complications of pregnancy, and chronic obstructive pulmonary disease. Each year, 440,000 deaths and $157 billion in health-related

economic costs result from tobacco use. Approximately 44.5 million people or 20.9 percent of

the adult population, reported smoking in 2004. Almost one-third of all tobacco users will die prematurely because of their dependence on tobacco. The morbidity and mortality caused by tobacco use, documented by the reports of the Surgeons General since 1964, are clear and pervasive. Smoking cessation is a dynamic process, and smokers generally make several quit attempts before succeeding. Although smoking cessation has been thoroughly studied, the dynamics of the smoking cessation process are still not completely understood. Some believe that smokers cycle through a sequence of stages in trying to quit, whereas others hypothesize that smokers move along a continuum of readiness to quit. Myriad influences can promote or impede smoking and smoking cessation, including personal factors, such as the smoker’s level of nicotine dependence, health, and social support for quitting; environmental influences, such as restrictions on smoking in public places, the price of cigarettes, and the extent of tobacco advertising and promotion in the area where the smoker lives; and tobacco control efforts, such as antismoking campaigns, telephone quit lines, and reduced price smoking cessation aids. Once a smoker decides to quit, he or she then chooses a cessation strategy. Some smokers decide to quit all at once without any assistance from others, whereas other smokers gradually reduce the number of cigarettes they smoke. Others may seek help from friends, family, counseling, nicotine replacement therapy (NRT), or other sources or use a combination of strategies. Intervention will only be effective if there are systems in place to assess and follow-up patients who want to quit smoking. Smoking has been identified as one of the most significant causes of avoidable death and disease. Despite the increase in public knowledge, and the push for smoke exposure reduction, the prevalence of smoking continues to represent a threat to the health and wellbeing of active and passive smokers alike. Programs that encourage smokers to quit have been described as effective tools in promoting health and reducing the burden of disease related to smoking. This brief review focuses on the forms of drug therapy that assist cessation; these treatments should be coordinated with the general and specific support and counseling strategies that are also of proven benefit. The brief discussion about the health care market, role of public and private insurance program, federal taxes on cigarettes,