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June 14, 1999

Treatment Options for the Weight-Conscious Smoker

Arch Intern Med. 1999;159(11):1169-1171. doi:10.1001/archinte.159.11.1169

OPTIONS FOR HELPING patients to stop smoking have improved dramatically over the past decade. An expanding array of pharmacologic products introduced since 1990 offer physicians and patients new ways to treat nicotine dependence, while randomized clinical trials have provided physicians with solid evidence to support their efforts to counsel smokers during routine office visits.1,2 Evidence-based clinical guidelines from the Agency for Health Care Policy and Research and other professional organizations now define treatment strategies for physicians and health care delivery systems.2 The rate at which physicians provide smoking cessation advice to patients has even become a quality-of-care measure for physicians and health plans.3 Nonetheless, treating smokers—especially the subset of hard-to-reach smokers—remains a challenge. All too often, patients who smoke are reluctant to consider quitting or repeatedly fail when they try. The reasons for this (eg, comorbid mood disorders, the use of other addictive substances, an environment saturated with smokers and smoking, and concern about gaining weight) have become clearer over the past decade, but research to identify ways to surmount these barriers has been scarce. The article by Marcus and colleagues4 in this issue is a welcome contribution with the potential to help solve a major obstacle to successful smoking cessation: fear of weight gain.

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