Smoking Cessation Author: Kumanan Wilson, MD
Editorial changes - 2010-01-07
Author information and module status
Key Points
Population at Risk
Effectiveness/Harms of Counseling or Intervention on Changing Behavior
Effectiveness/Harms of Behavior Change on Clinical Outcomes
Direct Effectiveness of Intervention/Counseling on Clinical Outcomes
Timeline
Cost-Effectiveness
Patient Education
Referral/Consultation
Guidelines
Tables
References
What's New
Patient Information
Additional Resources
Tools
Quality Measures Quality Measures
References
1. 1Clinical Practice Guideline. Treating Tobacco Use and Dependence. U.S. Department of Health and Human Services. Public Health Service. June 2000.
2. 1Grimshaw GM, Stanton A. Tobacco cessation interventions for young people. Cochrane Database Syst Rev. 2006:CD003289. (PMID: 17054164)
3. 2Doll R, Peto R, Wheatley K, Gray R, Sutherland I. Mortality in relation to smoking: 40 years' observations on male British doctors. Br Med J 1994; 309: 901-911. (PMID: 7755693)
4. 2Doll R, Gray R, Hafner B, Peto R. Mortality in relation to smoking: 22 years' observations of female British doctors. Br Med J 1980;967-971. (PMID: 7417764)
5. 2Wannamethee SG, Shaper AG, Whincup PH, Walker M. Smoking cessation and the risk of stroke in middle-aged men. JAMA. 1995;274:155-60. (PMID: 7596004)
6. 2LaCroix AZ, Lang J, Scherr P, Wallace RB, Cornoni-Huntley J, Berkman L et al. Smoking and mortality among older men and women in three communities. N Engl J Med 1991;324:1619-25. (PMID: 2030718)
7. 2Surgeon General. The Health Benefits of Smoking Cessation: A report of the Surgeon General. U.S. department of Health and Human Services (DHSS), Public Health Service (PHS), Center for Disease Control (CDC), Centre for Chronic Disease Prevention and Health Promotion, Office of Smoking and Health, DHSS Publication No. (CDC) 90-8416, 1990.
8. 2Wilson K, Gibson N, Willan A and Cook D. Effect of smoking cessation on mortality after myocardial infarction: meta-analysis of cohort studies. Arch Intern Med 2000;160:939-44. (PMID: 10761958)
9. 1Voors AA, Van Brussel BL, Plokker T, Ernst SMPG, Ernst NM, Koomen EM et al. Smoking and cardiac events after venous coronary bypass surgery. Circulation 1996; 93: 42-47. (PMID: 8616939)
10. 2Hasdai D, Garrat KN, Grill DE, Lerman A and Holmes Jr. DR. Effect of smoking status on the long-term outcome after successful percutaneous coronary revascularization. N Engl J Med 1997; 336: 755-761. (PMID: 9052653)
11. 2Hermanson B, Omenn GS, Kronmal RA and Gersh BJ. Beneficial six-year outcome of smoking cessation in older men and women with coronary artery disease. Results from the CASS registry. N Engl J Med 1988; 319: 1365-1369. (PMID: 3185646)
12. 2Vlietstra RE, Kronmal RA, Oberman A, Frye RL and Killip III T. Effect of cigarette smoking on survival of patients with angiographically documented coronary artery disease. Report form the CASS registry. JAMA 1986; 255: 1023-1027. (PMID: 3945013)
13. 2Rea TD, Heckbert SR, Kaplan RC, Smith NL, Lemaitre RN, Psaty BM. Smoking status and risk for recurrent coronary events after myocardial infarction. Ann Intern Med. 2002;137:494-500. (PMID: 12230350)
14. 2Mohiuddin SM, Mooss AN, Hunter CB, Grollmes TL, Cloutier DA, Hilleman DE. Intensive smoking cessation intervention reduces mortality in high-risk smokers with cardiovascular disease. Chest. 2007;131:446-52. (PMID: 17296646)
15. 1Anthonisen NR, Connet JE, Kiley JP, Altose MD, Bailey WC, Buist AS et al. for the Lung Health Study Research Group. Effects of smoking intervention and the use of an inhaled anticholinergic bronchodilator on the rate of decline of FEV1. The Lung Health Study. JAMA 1994;272:1497-1505. (PMID: 7966841)
16. 1Lumley J, Oliver S, Waters E. Interventions for promoting smoking cessation during pregnancy. Cochrane Database Syst Rev. 2000;CD001055. (PMID: 10796228)
17. 2Di Franza JR, Lew RA. Morbidity and mortality in children associated with the use of tobacco products by other people. Pediatrics 1996;97:560-8. (PMID: 8632946)
18. 1Taylor CB, Houston-Miller N, Killen JD and DeBusk RF. Smoking cessation after myocardial infarction: Effects of a nurse-managed intervention. Ann Intern Med 1990; 113: 118-123. (PMID: 2360750)
19. 1Law M, Tang JL. An analysis of the effectiveness of interventions intended to help people stop smoking. Arch Intern Med. 1995;155:1933-41. (PMID: 7575046)
20. 1Silagy C, Stead LF. Physician advice for smoking cessation. Cochrane Database Syst Rev. 2001;CD000165. (PMID: 11405953)
21. 1Hajek P, Taylor TZ, Mills P. Brief intervention during hospital admission to help patients to give up smoking after myocardial infarction and bypass surgery: randomised controlled trial. BMJ. 2002;324:87-9. (PMID: 11786452)
22. 1Moore L, Campbell R, Whelan A, Mills N, Lupton P, Misselbrook E, et al. Self help smoking cessation in pregnancy: cluster randomised controlled trial. BMJ. 2002;325:1383. (PMID: 12480850)
23. 2Rigotti NA, Munafo MR, Murphy MF, Stead LF. Interventions for smoking cessation in hospitalised patients (Cochrane Review). Cochrane Database Syst Rev. 2003;CD001837. (PMID: 12535418)
24. 1Lancaster T, Silagy C, Fowler G. Training health professionals in smoking cessation. Cochrane Database Syst Rev. 2000;CD000214. (PMID: 10908465)
25. 1Stead LF, Lancaster T. Group behaviour therapy programmes for smoking cessation. Cochrane Database Syst Rev. 2002;CD001007. (PMID: 12137615)
26. 1Lancaster T, Stead LF. Self-help interventions for smoking cessation. Cochrane Database Syst Rev. 2002;CD001118. (PMID: 12137618)
27. 3Rice VH, Stead LF. Nursing interventions for smoking cessation. Cochrane Database Syst Rev. 2001;CD001188. (PMID: 11686982)
28. 2Andrews JO, Felton G, Ellen Wewers M, Waller J, Tingen M. The effect of a multi-component smoking cessation intervention in African American women residing in public housing. Res Nurs Health. 2007;30:45-60. (PMID: 17243107)
29. 1de Vries H, Bakker M, Mullen PD, van Breukelen G. The effects of smoking cessation counseling by midwives on Dutch pregnant women and their partners. Patient Educ Couns. 2006;63:177-87. (PMID: 16406475)
30. 1Stead LF, Perera R, Lancaster T. Telephone counselling for smoking cessation. Cochrane Database Syst Rev. 2006;3:CD002850. (PMID: 16855992)
31. 1Zhu SH, Anderson CM, Tedeschi GJ, Rosbrook B, Johnson CE, Byrd M, et al. Evidence of real-world effectiveness of a telephone quitline for smokers. N Engl J Med. 2002;347:1087-93. (PMID: 12362011)
32. 1An LC, Zhu SH, Nelson DB, Arikian NJ, Nugent S, Partin MR, et al. Benefits of telephone care over primary care for smoking cessation: a randomized trial. Arch Intern Med. 2006;166:536-42. (PMID: 16534040)
33. 1Hajek P, Stead LF. Aversive smoking for smoking cessation. Cochrane Database Syst Rev. 2000;CD000546. (PMID: 10796558)
34. 1White AR, Rampes H, Ernst E. Acupuncture for smoking cessation. Cochrane Database Syst Rev. 2002;CD000009. (PMID: 12076375)
35. 1Abbot NC, Stead LF, White AR, Barnes J, Ernst E. Hypnotherapy for smoking cessation. Cochrane Database Syst Rev. 2000;CD001008. (PMID: 10796583)
36. 1Ussher MH, West R, Taylor AH, McEwen A. Exercise interventions for smoking cessation. Cochrane Database Syst Rev. 2000;CD002295. (PMID: 10908547)
37. 1Sillett RW, Wilson MB, Malcolm RE, Ball KP. Deception among smokers. Br Med J 1978; 28:1185-6. (PMID: 719343)
38. 1White AR, Rampes H, Campbell JL. Acupuncture and related interventions for smoking cessation. Cochrane Database Syst Rev. 2006:CD000009. (PMID: 16437420)
39. 1Roseby R, Waters E, Polnay A, Campbell R, Webster P, Spencer N. Family and carer smoking control programmes for reducing children's exposure to environmental tobacco smoke. Cochrane Database Syst Rev. 2003:CD001746. (PMID: 12917911)
40. 1Thomas R, Baker P, Lorenzetti D. Family-based programmes for preventing smoking by children and adolescents. Cochrane Database Syst Rev. 2007:CD004493. (PMID: 17253511)
41. 1Lancaster T, Hajek P, Stead LF, West R, Jarvis MJ. Prevention of relapse after quitting smoking: a systematic review of trials. Arch Intern Med. 2006;166:828-35. (PMID: 16636207)
42. 1Silagy C, Lancaster T, Stead L, Mant D, Fowler G. Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev. 2002;CD000146. (PMID: 12519537)
43. 1Blondal T, Gudmundsson LJ, Olafsdottir I, Gustavsson G, Westin A. Nicotine nasal spray with nicotine patch for smoking cessation: randomized trial with six year follow up. Brit Med J 1999;318:285-9. (PMID: 9924052)
44. 1Shiffman S, Dresler CM, Hajek P, Gilburt SJ, Targett DA, Strahs KR. Efficacy of a nicotine lozenge for smoking cessation. Arch Intern Med. 2002;162:1267-76. (PMID: 12038945)
45. 1Lancaster T, Stead LF. Mecamylamine (a nicotine antagonist) for smoking cessation. Cochrane Database Syst Rev. 2000;CD001009. (PMID: 10796584)
46. 1Yudkin P, Hey K, Roberts S, Welch S, Murphy M, Walton R. Abstinence from smoking eight years after participation in randomised controlled trial of nicotine patch. BMJ. 2003;327:28-9. (PMID: 12842953)
47. 1Hughes JR, Stead LF, Lancaster T. Antidepressants for smoking cessation. Cochrane Database Syst Rev. 2002;CD000031. (PMID: 11869562)
48. 1Hughes Jr, Stead L, Lancaster T. Antidepressants for smoking cessation. Cochrane Database Syst Rev. 2007:CD000031. (PMID: 17253443)
49. 1Jorenby DE, Leishow SJ, Nides MA, Rennard SI, Johnston JA, Hughes AR et al. A controlled trial of sustained-release bupropion, a nicotine patch, or both for smoking cessation. N Engl J Med 1999;340:685-91. (PMID: 10053177)
50. 1Hurt RD, Sachs DP, Glover ED, Offord KP, Johnston JA, Dale LC et al. A comparison of sustained-release bupropion and placebo for smoking cessation. N Engl J Med 1997; 337: 1195-1202. (PMID: 9337378)
51. 1Ahluwalia JS, Harris KJ, Catley D, Okuyemi KS, Mayo MS. Sustained-release bupropion for smoking cessation in African Americans: a randomized controlled trial. JAMA. 2002;288:468-74. (PMID: 12132977)
52. 1Jorenby DE, Hays JT, Rigotti NA, Azoulay S, Watsky EJ, Williams KE, et al. Efficacy of varenicline, an α4β2 nicotinic acetylcholine receptor partial agonist, vs placebo or sustained-release bupropion for smoking cessation: a randomized controlled trial. JAMA. 2006;296:56-63. (PMID: 16820547)
53. 1Gonzales D, Rennard SI, Nides M, Oncken C, Azoulay S, Billing CB, et al. Varenicline, an α4β2 nicotinic acetylcholine receptor partial agonist, vs sustained-release bupropion and placebo for smoking cessation: a randomized controlled trial. JAMA. 2006;296:47-55. (PMID: 16820546)
54. 1Tonstad S, Tonnesen P, Hajek P, Williams KE, Billing CB, Reeves KR, et al. Effect of maintenance therapy with varenicline on smoking cessation: a randomized controlled trial. JAMA. 2006;296:64-71. (PMID: 16820548)
55. 1Cahill K, Stead L, Lancaster T. Nicotine receptor partial agonists for smoking cessation. Cochrane Database Syst Rev. 2007:CD006103. (PMID: 17253581)
56. Etter JF. Cytisine for smoking cessation: a literature review and a meta-analysis. Arch Intern Med. 2006;166:1553-9. (PMID: 16908787)
57. 1Gourlay SG, Stead LF, Benowitz NL. Clonidine for smoking cessation. Cochrane Database Syst Rev. 2000;CD000058. (PMID: 10796479)
58. 1Stead LF, Hughes JR. Lobeline for smoking cessation. Cochrane Database Syst Rev. 2000;CD000124. (PMID: 10796490)
59. 1Lancaster T, Stead LF. Silver acetate for smoking cessation. Cochrane Database Syst Rev. 2000;CD000191. (PMID: 10796505)
60. 3Hughes JR, Stead LF, Lancaster T. Anxiolytics for smoking cessation. Cochrane Database Syst Rev. 2000;CD002849. (PMID: 11034774)
61. 1David S, Lancaster T, Stead LF, Evins AE. Opioid antagonists for smoking cessation. Cochrane Database Syst Rev. 2006:CD003086. (PMID: 17054160)
62. 1Working group for the study of transdermal nicotine in patients with coronary artery disease. Nicotine replacement therapy for patients with coronary artery disease. Arch Intern Med 1994; 154: 989-995. (PMID: 8179456)
63. 1Joseph AM, Norman SM, Ferry LH, Prochaza AV, Westman EC, Steele BG et al. The safety of transdermal nicotine as an aid to smoking cessation in patients with cardiac disease. N Engl J Med 1996; 335: 1792-1798. (PMID: 894316)
64. 1Greenland S, Satterfield MH, Lanes SF. A meta-analysis to assess the incidence of adverse effects associated with the transdermal nicotine patch. Drug Safety 1998;18:297-308. (PMID: 9565740)
65. 3Ottervanger JP, Festen JM, de Vries AG and Stricker BHC. Acute myocardial infarction while using the nicotine patch. Chest 1995; 107: 1765-1766. (PMID: 7781384)
66. 3Rigotti NA, Eagle KA. Atrial fibrillation while chewing nicotine gum (letter). JAMA 1986; 255: 1018. (PMID: 3945010)
67. 3Wooltorton E. Bupropion (Zyban, Wellbutrin SR): reports of deaths, seizures, serum sickness. CMAJ. 2002 Jan 8;166(1):68. (PMID: 11800252)
68. 2Negri E, La Vecchia C, D'Avanzo B, Nobili A, La Malfa RG. Acute myocardial infarction: association with time since stopping smoking in Italy. GISSI-EFRIM Investigators. Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto. Epidemiologia dei Fattori di Rischio dell'Infarto Miocardico. J Epidemiol Community Health 1994;48:129-33. (PMID: 8189165)
69. 2Dobson AJ, Alexander HM, Heller RF, Lloyd DM. How soon after quitting smoking does risk of heart attack decline? J Clin Epidemiol 1991;44:1247-53. (PMID: 1941018)
70. 2Flegal KM, Troiano RP, Pamuk ER, Kuczmarski RJ and Campbell SM. The influence of smoking cessation on the prevalence of overweight in the United States. N Eng J Med 1995; 333: 1165-1175. (PMID: 7565970)
71. 2Glassman AH, Covey LS, Stetner F, Rivelli S. Smoking cessation and the course of major depression: a follow-up study. Lancet 2001;357:1929-32. (PMID: 11425414)
72. 1Anthonisen NR, Connett JE, Enright PL, Manfreda J. Hospitalizations and mortality in the Lung Health Study. Am J Respir Crit Care Med. 2002;166:333-9. (PMID: 12153966)
73. 1Anthonisen NR, Skeans MA, Wise RA, Manfreda J, Kanner RE, Connett JE. The effects of a smoking cessation intervention on 14.5-year mortality: a randomized clinical trial. Ann Intern Med. 2005;142:233-9. (PMID: 15710956) [Full Text]
74. 2US Department of Health and Human Services. Preventing tobacco use among young people. A report of the Surgeon General. Atlanta (GA): US Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. 1994.
75. 2Dunner DL, Zisook S, Billow AA, Batey SR, Johnston JA and Ascher JA. A prospective safety surveillance study for bupropion sustained-release in the treatment of depression.J Clin Psychiatry 1998; 59:366-73. (PMID: 9714265)
76. 1Hajek P, West R, Foulds J, Nilsson F, Burrows S, Meadow A. Randomized comparative trial of nicotine polacrilex, a transdermal patch, nasal spray, and an inhaler. Arch Intern Med. 1999;159:2033-8. (PMID: 10510989)
77. 2Eggers P. Comparison of treatment costs between dialysis and transplantation. Semin Nephrol. 1992;12:284-9. (PMID: 1615249)
78. 1Fiscella K, Franks P. Cost-effectiveness of the transdermal nicotine patch as an adjunct to physicians’ smoking cessation counseling. JAMA 1996;275:1247-51. (PMID: 8601956)
79. 2Bolin K, Lindgren B, Willers S. The cost utility of bupropion in smoking cessation health programs: simulation model results for Sweden. Chest. 2006;129:651-60. (PMID: 16537864)
80. 2Krumholz HM, Cohen BJ, Tsevat J, Pasternak RC, Weinstein MC. Cost-effectiveness of a smoking cessation program after myocardial infarction. J Am Coll Cardiol 1993; 22: 1697-1702. (PMID: 8227841)
81. 2Lightwood JM, Phibbs CS and Glantz SA. Short-term health and economic benefits of smoking cessation: low birth weight. Pediatrics. 1999;104:1312-20. (PMID: 10585982)
82. 2Marks JS, Koplan JP, Hogue CJ, Dalmat ME. Costs of maternal conditions attributable to smoking during pregnancy. Am J Prev Med. 1998;15:212-9. (PMID: 9791639)
New References of Interest
83. Yeh HC, Duncan BB, Schmidt MI, Wang NY, Brancati FL. Smoking, smoking cessation, and risk for type 2 diabetes mellitus: a cohort study. Ann Intern Med. 2010;152:10-7. (PMID: 20048267) [Full Text]
84. Smith SS, McCarthy DE, Japuntich SJ, Christiansen B, Piper ME, Jorenby DE, Fraser DL, Fiore MC, Baker TB, Jackson TC. Comparative effectiveness of 5 smoking cessation pharmacotherapies in primary care clinics. Arch Intern Med. 2009;169:2148-55. (PMID: 20008701)
85. Suzuki T, Matsuo K, Ito H, Sawaki A, Hirose K, Wakai K, et al. Smoking increases the treatment failure for Helicobacter pylori eradication. Am J Med. 2006;119:217-24. (PMID: 16490464)
86. Piper ME, Smith SS, Schlam TR, Fiore MC, Jorenby DE, Fraser D, et al. A randomized placebo-controlled clinical trial of 5 smoking cessation pharmacotherapies. Arch Gen Psychiatry. 2009;66:1253-62. (PMID: 19884613)
87. Gunnell D, Irvine D, Wise L, Davies C, Martin RM. Varenicline and suicidal behaviour: a cohort study based on data from the General Practice Research Database. BMJ. 2009;339:b3805. (PMID: 19797344)
88. Stewart ST, Cutler DM, Rosen AB. Forecasting the effects of obesity and smoking on U.S. life expectancy. N Engl J Med. 2009;361:2252-60. (PMID: 19955525)
89. Shipton D, Tappin DM, Vadiveloo T, Crossley JA, Aitken DA, Chalmers J. Reliability of self reported smoking status by pregnant women for estimating smoking prevalence: a retrospective, cross sectional study. BMJ. 2009;339:b4347. (PMID: 19875845)
FAQs
Edward Ellerbeck, MD, MPH, editorial consultant, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Kumanan Wilson, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Darren B. Taichman, MD, PhD, Editor, PIER, has received grant support from Actelion Pharmaceuticals Ltd , and honoraria for continuing medical education grand rounds and lectures given.

The information included herein should never be used as a substitute for clinical judgment and does not represent an official position of ACP. Because all PIER modules are updated regularly, printed web pages or PDFs may rapidly become obsolete. Therefore, PIER users should compare the date of the last update on the website with any printout to ensure that the information being referred to is the most current available.
PIER is copyrighted (c) 2010 by the American College of Physicians,
190 N. Independence Mall West, Philadelphia, PA 19106-1572, USA.