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Introduction Smoking is considered the most important modifiable risk factor in the US for cancer and cardiovascular and pulmonary disease All adults should be screened regularly for tobacco use Smoking cessation should be discussed with all smokers at EVERY clinical contact most likely to reduce mortality Therapies for smoking cessation include: nicotine replacement bupropion varenicline cognitive behavioral therapy (CBT) combination therapy (multiple treatments from above) are the most effective Nicotine Replacement Comes in many forms including: gum inhaler lozenge patch spray Many forms can be purchased over the counter Gums, inhalers, lozenges are excellent for combatting acute cravings Patches ideal for delivering a basal rate of nicotine Varenicline (Chantix) Nicotinic receptor partial agnoist Prescription only Therapy should begin 1 week prior to quit date and then continued 4 months after quit date Very effective when combined with nicotine therapy (older sources say NOT to combine them) Side effects: headache nausea insomnia Warnings: may cause neuropsychiatric symptoms or increased suicidality avoid in patients with history of unstable psychiatric symptoms or suicidality Create a free account or log in to see the cards.