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Tobacco use disorder — USMLE Step 3 MCQ

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EasyAmbulatory Medicine / Primary CareTobacco use disorderUSMLE Step 3

A 45-year-old woman with a 25-pack-year smoking history wants help quitting. Nicotine gum was ineffective. She has no seizure disorder, bipolar disorder, current depression, or pregnancy. She asks for medication to reduce craving. Which of the following is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Start varenicline with behavioral support

Varenicline is an effective first-line smoking cessation medication when not contraindicated and should be combined with behavioral support.

Reference: USPSTF A and B recommendations, https://www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-a-and-b-recommendations