The future of smoking cessation therapy in the United States.

Six trends that are likely to influence the future content, format, delivery and reach of smoking cessation therapy in the United States are discussed: (1) changing characteristics of smokers (e.g. more likely to be poor, have psychiatric co-morbidity and be more nicotine dependent), (2) health care reform demands for cost-effectiveness, (3) development of guidelines/algorithms that recommend stepped-care approaches, (4) continued emphasis on smoking as a form of drug dependence requiring intensive pharmacological and behavior therapy for some smokers, (5) interest in harm-reduction strategies for smokers unable or unwilling to quit (and 6) smoking cessation therapies become reimbursable on par with other drug dependencies.