The Medical clinics of North America
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Smokeless tobacco (ST) use is an important health issue in the United States, and chronic use leads to significant morbidity. ST users are exposed to levels of nicotine comparable with smokers and experience symptoms of nicotine withdrawal when attempting to stop. Clinical treatment of ST users requires an understanding of the unique characteristics of ST. This article reviews ST products, epidemiology, pharmacology, health risks, and treatment approaches.
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Smoking cessation activities and support for its implementation should be integrated into the health care system. The outcome of smoking cessation has improved with the availability of proper behavior approaches and medications. Incorporating these guidelines into daily clinical practice ensures that health care providers provide the opportunity for patients to quit smoking. The best hope of improved treatment comes from combining existing and new pharmacotherapies with effective behavioral therapy.