Much progress has been made in recent years in treating tobacco dependence. The 2000 USPHS Guideline extends the understanding of effective treatments and encourages clinicians to be more diligent in recognizing tobacco users in the practice and more aggressive in treating every tobacco user. The guideline outlines the potential use of the five first-line medications (bupropion, nicotine patches, gum, nasal spray, and inhaler) and the two second-line medications (nortriptyline and clonidine). The use of these medications can be tailored to meet the patients needs and combinations of these medications can be used when appropriate. More intensive treatment, such as residential treatment, may be needed for more addicted smokers.
aIntervention Section, Medicine Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland USA
bUniversity of South Florida, and Moffitt Cancer Center, Tampa, Florida USA
cDifferentiation Control Section, Laboratory of Cellular Carcinogenesis and Tumor Promotion, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland USA
Address reprint requests to: James L. Mulshine, MD, Intervention Section Center for Cancer Research National Cancer Institute Building 10, Room 12N 226 Clinical Center National Institutes of Health Bethesda, MD 20892