Smoking cessation: recent developments in behavioral and pharmacologic interventions.

Smoking kills more than 430,000 people each year in the United States and is currently estimated to be responsible for 30.5% of all cancer-related deaths in our society. The majority of these deaths could be prevented, however, if people refrained from usage of tobacco products. It is, therefore, essential that smoking cessation treatment become an integral component of all types of health care. In order to help clinicians better serve their smoking patients, we present an overview of current trends in the behavioral and pharmacologic treatment of smoking cessation. Although popular with patients, standard self-help interventions provide little clinical utility. A review of the current literature supports the use of behavioral counseling and nicotine replacement therapy as the most efficacious forms of intervention, particularly when combined. Recent trends in cessation research have also included nonnicotine medications, such as antidepressants, anxiolytics, and nicotine antagonists. Although there is insufficient evidence to mandate inclusion of most of these medications in standard smoking cessation treatment at this time, preliminary studies have not ruled out their potential effectiveness.