Treatment of tobacco dependence

Tobacco dependence is a chronic condition that often requires repeated assessment, intervention, and multiple attempts to quit. This chapter describes principles underlying treatments for tobacco dependence that have been elucidated in the guidelines for smoking cessation. A common thread in the guidelines is the use of the 5As consisting of asking about smoking, advising on quitting, assessing nicotine dependence, and stage of readiness to change, assisting with smoking cessation using a range of components of interventions, and follow up to monitor progress. There are many effective components of treatments for smokers that produce long-term permanent abstinence. Cognitive behavioural counselling and pharmacotherapy increase the likelihood of cessation and clinicians should recommend these treatments to smokers. A multipronged approach is important to assist smokers to quit including reinforcement of non-smoking from several clinicians using a variety of evidence-based smoking cessation techniques.