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Smoking cessation — USMLE Step 3 MCQ

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ModerateAmbulatory Medicine / Primary CareSmoking cessationUSMLE Step 3

A 58-year-old man with COPD returns 4 weeks after a visit for smoking cessation. He smokes 1 pack per day, tried nicotine patches previously, and relapsed within 2 weeks. He is motivated to quit, has no seizure history, and does not drink alcohol heavily. Mood is stable. Which of the following would you recommend at the follow-up visit?

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

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Correct answer: A — Offer varenicline with behavioral support

Varenicline and counseling are effective first-line smoking cessation interventions in motivated adults, including those with chronic lung disease.

Reference: USPSTF Tobacco Smoking Cessation in Adults, 2021