Smoking cessation strategies for the 21st century.

Abstract

Cigarette smoking is the leading preventable cause of illness and premature death in the United States, claiming over 400 000 lives a year because it directly increases the risk of dying from heart disease, stroke, emphysema, and a variety of cancers.1 Approximately 25% of adults in the United States continue to smoke, despite information about the unequivocally negative health consequences of smoking.2 Part of the reason for continued cigarette smoking is the addictive nature of nicotine, a substance found in all types of tobacco products. In the 1988 Surgeon General’s Report on the Health Consequences of Smoking ,3 nicotine was declared an addictive drug similar to heroin or cocaine. It is important to emphasize that nicotine itself is probably not responsible for most of the negative health consequences of smoking. Instead, persons who stop using nicotine-containing tobacco products experience an unpleasant withdrawal syndrome that may include such …