Smoking Cessation
What Is It?
Tobacco use disorder - nicotine dependence - is the leading preventable cause of death. Cessation requires behavioral and pharmacological support. Most patients need multiple attempts.
How Is It Diagnosed?
Fagerstrom Test for Nicotine Dependence. Assess stage of change (precontemplation to action). Screen for depression and anxiety.
How Is It Treated?
First-line pharmacotherapy: varenicline (most effective), combination NRT (patch + gum/lozenge), or bupropion. 5 As counseling framework. Quitline referral (1-800-QUIT-NOW).
Tests and Imaging Typically Needed
Spirometry (assess COPD), chest X-ray, CBC, carbon monoxide level if occupational exposure.
Approximate Self-Pay Costs
Office visit: $95-$150. Varenicline: $150-$200/month (manufacturer coupons available). NRT patch: $30-$60/month. Many insurance plans cover cessation medications.