[Treatment of tobacco use. Pediatric aspects]

To divulge among pediatricians therapeutic modalities against tobacco use.

Literature review of therapeutic modalities, their efficacy indications, secondary effects and scientific value. Relapse-related factors are analyzed.

Tobacco use generates physical (nicotine) and psychological addiction. Treatment strategies should consider both aspects. Different therapies have been applied with unequal results: (1) medical information; (2) pharmacologic treatment: symptomatic drugs and nicotine; (3) therapy psychological including positive reinforcement, aversive techniques and hypnosis; (4) other modalities such as acupuncture, collective and self-obtainment. Relapses have been related to nicotine abstinence syndrome and individual, familiar, professional and social factors.

Pediatricians should engage to tobacco use treatment. Proper medical information will induce patient commitment to stop smoking, aided by nicotine therapy and psychological support. Relapses should be anticipated and adequately approached. Pediatricians have at hand the best available treatment: to prevent adolescents and young adults to start smoking.