Cigarette smoking is a major risk factor for cardiovascular disease (CVD) and death from CVD. In fact, nearly one-third of U.S. deaths attributed to cigarette smoking are due to CVD. Although most smokers attempt to quit multiple times before they are able to call it quits, many do not stop smoking until they have developed smoking-related complications. Quitting smoking reduces subsequent CV events and mortality, regardless of duration or intensity of smoking, comorbidities or age. Patients benefit even when they quit smoking after they have developed CVD. This provides a strong rationale for quitting-if only the best way to accomplish this were known. Physicians have had little guidance to use in counseling patients on the most effective strategies to stop smoking. The American College of Cardiology addressed this need with an Expert Consensus Decision Pathway on TobaccoCessation Treatment (Journal of the American College of Cardiology
, Dec. 25, 2018). It summarizes recommendations for a comprehensive approach to treating tobacco dependence with a chronic disease management strategy, monitoring tobacco use over time and making repeated efforts to encourage and assist smokers to quit using tobacco. The document gives physicians the information they need to answer smokers' questions about therapies for overcoming nicotine withdrawal, while bolstering self-control over smoking. It also discusses barriers to implementing and sustaining smoking cessation treatment that should be recognized and addressed to help smokers overcome their addiction to tobacco.