Journal of General Internal Medicine

, Volume 18, Issue 12, pp 1053–1057

Motivating and helping smokers to stop smoking


DOI: 10.1111/j.1525-1497.2003.20640.x

Cite this article as:
Hughes, J.R. J GEN INTERN MED (2003) 18: 1053. doi:10.1111/j.1525-1497.2003.20640.x


Smokers try to quit only once every 2 to 3 years and most do not use proven treatments. Repeated, brief, diplomatic advice increases quit rates. Such advice should include a clear request to quit, reinforcing personal risks of smoking and their reversibility, offering solutions to barriers to quitting, and offering treatment. All smokers should be encouraged to use both medications and counseling. Scientifically proven, first-line medications are nicotine gum, inhaler, lozenge, and patch plus the nonnicotine medication bupropion. Proven second-line medications are clonidine, nicotine nasal spray, and nortriptyline. These medications are equally effective and safe and the incidence of dependence is very small. The proven psychosocial therapies are behavioral and supportive therapies. These are as effective as medications and are effective via individual counseling, group, and telephone formats.

The writing of this article was supported in part by Senior Scientist Award DA-00450 from the National Institute on Drug Abuse.

Key words

nicotine smoking tobacco use disorders treatment 

Copyright information

© Society of General Internal Medicine 2003

Authors and Affiliations

  1. 1.Received from the Departments of Psychiatry, Psychology, and Family PracticeUniversity of VermontBurlington

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