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August 14, 1996

Clinical Practice Guidelines for Smoking Cessation

Author Affiliations

University of Wisconsin Medical School Madison

JAMA. 1996;276(6):448. doi:10.1001/jama.1996.03540060024016

—Dr Perry raises an important point in regard to the role of pediatricians in both primary and secondary prevention. The AHCPR Smoking Cessation Guideline Panel considered at some length inclusion of a primary prevention section, but felt it was of sufficient scope to merit its own guideline. As Perry's description of his smoking cessation program for adults indicates, pediatricians have a unique role to play in smoking cessation, given the connection between a child's health and the smoking behavior of adult caretakers.

Dr Merrick argues strongly that the magnitude of nicotine addiction requires intensive, long-term treatment for a successful outcome. Some patients do benefit from more intense and sustained treatment; indeed, the meta-analyses that provided the scientific support for the AHCPR Smoking Cessation Clinical Practice Guideline found a strong, positive doseresponse relationship between both intensity and duration of treatment and successful cessation. As a result, this finding was the basis