Interventions for treatment-resistant smokers.

We can understand resistance to treatment in smokers in two ways. First, when there is no awareness that smoking can be responsible for a physical disease, e.g., chronic obstructive lung disease or a dependence disorder. Second, when smokers actually seek treatment but fail to respond positively. The first kind-resistance related to lack of awareness-may not be so common in adult US smokers, but is more common among young smokers. Information is crucial to increase awareness. However, such information must be presented in such a way that smokers respond to it. Whether a smoker takes action will also depend on what options and choices are available. Encouraging abrupt cessation as the only option is unlikely to motivate the smokers who have tried to quit many times and failed and those who do not want to give up completely. Alternatives such as quitting gradually-even harm-minimization-should be considered. Hopefully, taking some control over smoking with the help of, for example, nicotine replacement can increase self-efficacy and motivation to quit. For those who find it impossible to quit, harm-minimization procedures should definitely be invoked.