#252 Smoking Cessation Unfiltered

Tobacco use disorder functions as a chronic, relapsing disease requiring a biopsychosocial approach rather than short-term interventions. Dr. Steve Baldassarri, an addiction medicine expert from Yale School of Medicine, emphasizes that clinicians must move beyond simple advice to provide long-term, intensive management. Effective treatment involves combining controller pharmacotherapy—such as varenicline or nicotine patches—with short-acting nicotine replacement to manage persistent cravings. Because smoking is often deeply intertwined with social stressors and mood disorders, integrating behavioral support like motivational interviewing is essential for patient success. While vaping may serve as a last-resort harm reduction tool for those who fail standard therapies, it remains an unproven long-term strategy. Clinicians should prioritize aggressive, evidence-based medication dosing and consistent follow-up to support patients through the difficult, often multi-year process of achieving and maintaining abstinence.