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  1. There is a strong behavioral component to tobacco dependence that should be addressed with behavioral support.
  2. There are 5 steps to basic, behavioral tobacco interventions:
    • Ask about tobacco use.
    • Advise patients not to use tobacco.
    • Assess whether tobacco-using patients are interested in quitting.
    • Assist patients who are ready to quit or who are in the quitting process. Assist patients who are at other stages in the tobacco cessation cycle in moving to the next stage.
    • Arrange for follow-up.
  3. Tobacco dependence has a very strong biological component (nicotine addiction) that often requires pharmacological intervention along with behavioral interventions for the best chance of successful abstinence.
  4. This course presented detailed information on first-line smoking deterrent medications (drugs that improve smoking abstinence rates and are approved by the FDA for that purpose) and second-line smoking deterrents (drugs that show some evidence of improving abstinence rates but are not approved by the FDA for that purpose). The drugs for smoking cessation are as follows:

    • First-line smoking deterrents
      • bupropion (Zyban®)
      • nicotine inhaler
      • nicotine gum
      • nicotine nasal spray
      • nicotine patch
      • nicotine lozenge (Commit®)
      • varenicline (Chantix®

    • Second-line smoking deterrents
      • clonidine
      • nortriptyline