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Smoking cessation — ABIM Board MCQ

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ModeratePulmonary/Critical CareSmoking cessationABIM Board

A 49-year-old who smokes daily wants to quit. Depression is stable on sertraline, there is no seizure history and nicotine-patch monotherapy previously failed. Which intervention offers an evidence-based next attempt?

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Correct answer: A — Offer varenicline together with behavioral counseling

The best answer is “Offer varenicline together with behavioral counseling”. Varenicline is an effective FDA-approved cessation medicine and combining pharmacotherapy with behavioral support improves quit success. Stable treated depression is not by itself a contraindication. Benzodiazepines and antibiotics do not treat nicotine dependence, and evidence is insufficient to recommend e-cigarettes as a clinical cessation intervention.

Reference: USPSTF Tobacco Smoking Cessation Recommendation: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/tobacco-use-in-adults-and-pregnant-women-counseling-and-interventions