Overcoming barriers to nicotine dependence treatment.

Tobacco dependence is the most overlooked and undertreated preventable cause of chronic disease in the developed world. Three barriers to effective treatment must be overcome: the reluctance of nicotine addicts to seek help; inadequate training of health professionals to treat hard core smokers; and a health care system that does not acknowledge the need for professional treatment of nicotine addiction. Effective physicians are equipped with the knowledge and skills to identify high-risk smokers who need more assistance to quit. All smokers should be engaged in a tailored office intervention based on their needs. Adoption of simple clinical protocols can eliminate the barriers that prevent effective counseling and treatment in the office setting.