Treatment Recommendations for Tobacco Use

The Standard of Care of tobacco treatment, regardless of the population or the type of tobacco used, is pharmacotherapy and counseling. Appropriate use of tobacco dependence medications reduces withdrawal symptoms and nearly doubles the chances of success for a given quit attempt. Delivering such treatments is cost-effective and is a key part of a multi-faceted approach to help patients stop smoking.

There are seven first-line medications that reliably increase long-term smoking abstinence rates.


  • Nicotine gum
  • Nicotine inhaler
  • Nicotine lozenge
  • Nicotine nasal spray
  • Nicotine patch


  • Bupropion SR
  • Varenicline

Clinicians should also consider the use of certain combinations of medications identified as effective in the Guideline.

  • Long-term (>14 weeks) nicotine patch + other NRT
  • The nicotine patch + the nicotine inhaler
  • The nicotine patch + Bupropion SR


Key Point: Encourage patients making a quit attempt to use both counseling and medication. Counseling and medication are effective when used by themselves for treating tobacco dependence. However, the combination of counseling and medication is more effective than either one alone.