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August 14, 1996

Clinical Practice Guidelines for Smoking Cessation

Author Affiliations

Kaiser Permanente Chemical Dependency Recovery Program Carson, Calif

JAMA. 1996;276(6):448. doi:10.1001/jama.1996.03540060024015

To the Editor.  —The Agency for Health Care Policy and Research (AHCPR) Smoking Cessation Clinical Practice Guideline1 presents useful strategies for some patients with nicotine addiction. The low quit rates typically achieved by this approach reflect a failure to recognize that a majority of nicotine-dependent patients require more intensive therapy.Even the recommendations regarding intensive cessation programs are not sufficient in intensity or duration for most smokers. Would anyone ever consider such a minimalist approach to other addictions such as alcohol, cocaine, or heroin?These guidelines trivialize nicotine addiction. I propose future guidelines incorporate an addiction-model treatment approach to this most significant problem and include greatly expanded intensity and duration of treatment.