Highlights & Basics
- Healthcare professionals play a central role in motivating and assisting people to quit smoking.
- Smoking cessation benefits all people who smoke regardless of age, comorbidities, or current health problems.
- The 5 A's is a five-step treatment framework to guide smoking cessation that is used across the world in many treatment settings; abbreviated variants are also available, increasing in usage, and preferentially recommended in some countries and within certain treatment settings.
- The combination of behavioral counseling plus an evidence-based pharmacotherapy for smoking cessation has the best evidence for smoking cessation. Of the available pharmacologic options, nicotine replacement therapy (NRT) in combination with varenicline have amassed the greatest volume of data demonstrating safety and efficacy.
- The use of e-cigarettes for smoking cessation remains a topic of ongoing debate and research; professional medical bodies in different countries have varying stances on e-cigarettes based on the available evidence and public health considerations.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Images
Prompt for smoking, with additional questions automatically opened depending on each answer
Prompt for e-cigarette use, typically completed by the intake staff and discussed by the healthcare provider
Example script and color-coded sticker system for identifying smoking status with vital signs
Example method to indicate smoking status on the vital signs record
Questionnaire to assess and improve motivation and self-confidence for quitting effort
Citations
United States Public Health Service Office of the Surgeon General; National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health. Smoking cessation: a report of the Surgeon General. 2020 [internet publication].[Abstract][Full Text]
Tobacco Use and Dependence Guideline Panel, US Department of Health and Human Services. Treating tobacco use and dependence: 2008 update. Rockville (MD): US Department of Health and Human Services; 2008.[Full Text]
National Institute for Health and Care Excellence. Tobacco: preventing uptake, promoting quitting and treating dependence. Feb 2025 [internet publication].[Full Text]
US Preventive Services Task Force. Interventions for tobacco smoking cessation in adults, including pregnant persons: US Preventive Services Task Force recommendation statement. JAMA. 2021 Jan 19;325(3):265-79.[Abstract][Full Text]
Barua RS, Rigotti NA, Benowitz NL, et al. 2018 ACC expert consensus decision pathway on tobacco cessation treatment: a report of the American College of Cardiology Task Force on clinical expert consensus documents. J Am Coll Cardiol. 2018 Dec 5;72(25):3332-65.[Abstract][Full Text]
Hartmann-Boyce J, Chepkin SC, Ye W, et al. Nicotine replacement therapy versus control for smoking cessation. Cochrane Database Syst Rev. 2018 May 31;(5):CD000146.[Abstract][Full Text]
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125. Cahill K, Stevens S, Perera R, et al. Pharmacological interventions for smoking cessation: an overview and network meta-analysis. Cochrane Database Syst Rev. 2013 May 31;(5):CD009329.[Abstract][Full Text]
126. Hajizadeh A, Howes S, Theodoulou A, et al. Antidepressants for smoking cessation. Cochrane Database Syst Rev. 2023 May 24;(5):CD000031.[Abstract][Full Text]
127. Hartmann-Boyce J, Chepkin SC, Ye W, et al. Nicotine replacement therapy versus control for smoking cessation. Cochrane Database Syst Rev. 2018 May 31;(5):CD000146.[Abstract][Full Text]
128. Lindson N, Theodoulou A, Ordóñez-Mena JM, et al. Pharmacological and electronic cigarette interventions for smoking cessation in adults: component network meta-analyses. Cochrane Database Syst Rev. 2023 Sep 12;(9):CD015226.[Abstract][Full Text]
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130. Livingstone-Banks J, Fanshawe TR, Thomas KH, et al. Nicotine receptor partial agonists for smoking cessation. Cochrane Database Syst Rev. 2023 Jun 28(6):CD006103.[Abstract][Full Text]
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