Treating Tobacco Use and Dependence: 2008 Update U.S. Public Health Service Clinical Practice Guideline Executive Summary

By M. Fiore, C. Jaén, N. Benowitz, S. Curry, S. F. Dorfman, P. Henderson. Respiratory care, 2008

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The 1996 Smoking Cessation Clinical Practice Guideline1 emphasized the dire health consequences of tobacco use and dependence, the existence of effective treatments, and the importance of inducing more smokers to use such treatments. It also called for newer, even more effective tobacco dependence treatments. All of these points still are germane. Nevertheless, heartening progress has been made in tobacco control since that time, and this progress is part of a larger pattern of change that stretches back over the past 40 years. This progress reflects the achievements of clinicians, the public health community, scientists, government agencies, health care organizations, insurers, purchasers, and smokers who have successfully quit. As a result, the current prevalence of tobacco use among adults in the United States (about 20.8%) is less than half the rate observed in the 1960s (about 44%).2, 3 This Guideline concludes that tobacco use presents a rare confluence of circumstances: (1) a highly significant health threat;4 (2) a disinclination among clinicians to intervene consistently;5 and (3) the presence of effective interventions. This last point is buttressed by evidence that tobacco dependence interventions, if delivered in a timely and effective manner, significantly reduce the smoker’s risk of suffering from smoking-related disease.6-13 Indeed, it is difficult to identify any other condition that presents such a mix of lethality, prevalence, and neglect, despite effective and readily available interventions.

Subfields: Pharmacology, Physiology, Public Health, Environmental and Occupational Health

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