[Smoking cessation: practice guidelines]

Smoking is a habit sustained and amplified by dependency on nicotine. Despite knowing the risks to their health, smokers have great difficulty in stopping. The syndrome of nicotine withdrawal and the related complications when stopping smoking: depression, weight gain, are adequate justifications of the many failures to stop smoking. However, we have now come out of the empiricism, effective treatment is available and scientifically validated international recommendations have been established. They involve: the practice of minimal advice which consists of questioning every patient about smoking habits and encouraging them to stop; the treatments of nicotine substitution, patch, chewing gum, tablets or inhaler, used at effective dosage and sometimes in association with each other; more recently, Bupropion (Zyban, LP), a psychotropic inhibitor of Dobutamine and Noradrenalin recapture; behavioural and cognitive therapies, alone or in association with pharmacological therapy. The measurement of the score of tobacco dependency with the Fagerström test enables definition of a therapeutic strategy. Of course, these treatments are only effective in smokers motivated to stop smoking. The decision to stop smoking should only be taken after a period of reflection during which the role of information and advice given by all health professionals is primordial. Also, the long-term follow-up and counsel are essential to prevent relapse, especially during the first year.