Physicians should treat smoking as a chronic disease if they want to help their patients quit successfully. Patients may require repeated or intensive interventions that include pharmacotherapy and counseling, as well as continued dialogue with their physicians. Researchers studied 750 primary care patients who smoked at least 10 cigarettes a day to determine which interventions worked best to help them quit. Participants were randomly assigned to pharmacotherapy (nicotine patch or bupropion), pharmacotherapy supplemented with up to two calls from trained counselors, or pharmacotherapy supplemented with up to six counseling calls. During the two-year study, patients in the high-intensity counseling group were the most successful. "These studies show the importance of taking a disease management approach to smoking cessation," said Edward Ellerbeck, M.D., Associate Professor and Chair of the Department of Preventive Medicine and Public Health at the University of Kansas, and lead author of the study. "We found that smokers are willing to make repeated medically-assisted attempts at quitting smoking, resulting in progressively greater smoking abstinence. Physicians should talk to their patients continually about quitting, and should facilitate access to a smoking cessation medication."

Submitted by the American College of Physicians