Snapshot A 69-year-old male presents with concerns about his declining health. His brother recently died of renal cell carcinoma and he is now concerned about his own health. The patient has a history of type II diabete mellitus, HTN and a 50 pack-year smoking history. He asks you what he can do to improve his health. Introduction Smoking is considered the most important modifiable risk factor in the US for cancer and cardiovascular and pulmonary disease All adults should be screened regularly for tobacco use Smoking cessation should be discussed with all smokers at EVERY clinical contact login to view 1 more bullet Therapies for smoking cessation include: login to view 5 more bullets Nicotine Replacement Comes in many forms including: login to view 5 more bullets Many forms can be purchased over the counter Gums, inhalers, lozenges are excellent for combatting acute cravings Patches ideal for delivering a basal rate of nicotine Bupropion (Zyban) Varenicline (Chantix) Nicotinic receptor partial agnoist Prescription only login to view 1 more bullet Very effective when combined with nicotine therapy (older sources say NOT to combine them) Side effects: login to view 4 more bullets Warnings: login to view 2 more bullets Cognitive Behavioral Therapy (CBT) CBT is a form of psychotherapy that targets changing maladaptive thinking patterns and the negative behaviors associated with them Not been found to be highly effective when used alone for smoking cessation May be helpful when employed with some of the therapies listed above