Clinical Interventions in Tobacco Control: A National Cancer Institute Training Program for Physicians

SMOKING is the leading preventable cause of death in our country. Smoking kills 434 000 people a year, more than 1000 every day 1 ; it accounts for about 85% of all lung cancer deaths, about 80% of all chronic obstructive pulmonary disease deaths, and 30% of all heart disease deaths. In addition, smoking costs this country $52 billion annually in health care and other costs. 2 In spite of the magnitude of this health hazard, most physicians have never received training in techniques to help patients stop smoking. Many physicians believe they are unprepared and unsuccessful in treating patients addicted to nicotine. 3,4 However, recent scientific evidence suggests that physicians can help smokers stop and thus reduce the incidence of smoking-related diseases. In 1989, the National Cancer Institute (NCI) used clinical trial results and consensus development to produce recommendations for physicians who treat patients