US PHS 2008 — Treating Tobacco Use and Dependence: 2008 Update
| Field | Value |
|---|---|
| Issuing body | US Public Health Service (Clinical Practice Guideline) |
| Year | 2008 (updated from 2000) |
| Scope | Clinical treatment of tobacco dependence in adults |
| Source | Treating Tobacco Use and Dependence: 2008 Update (AHRQ) |
Key positions (as published in 2008)
- Tobacco dependence is a chronic condition that often requires repeated intervention.
- Counselling and medication are each effective; combining them is more effective than either alone.
- Seven first-line medications were identified as effective: five NRT forms (gum, patch, lozenge, inhaler, nasal spray), bupropion SR and varenicline.
- Clinicians should use the 5 A's model: Ask, Advise, Assess, Assist, Arrange follow-up.
- Quitlines (e.g., 1-800-QUIT-NOW in the US) are effective and should be promoted.
Status today
The 2008 guideline is the classic US reference but predates: the EAGLES safety trial (2016), cytisine trials, the e-cigarette evidence base and the 2020 Surgeon General report. It remains cited here because its central findings — dependence is chronic, treatment works, combination beats monotherapy — remain the foundation of every later guideline. For current US recommendations see USPSTF 2021.