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According to the U.S. Centers for Disease Control and Prevention (1), 21% of American adults (44.5 million people) and 22% of American high school students (3.75 million people) smoke cigarettes. Although per capita tobacco use in the United States has decreased dramatically since the 1950s, it is unlikely that the United States will reach the Healthy People 2010 objectives of reducing smoking prevalence to less than 12% in adults and less than 16% in youth (2). Tobacco use is an even bigger public health threat in many regions outside of the United States. Many people who smoke wish that they could stop, but quitting is difficult and failure is common. Some, of course, do succeed in quitting permanently. In 2004, the CDC estimated that 45.6 million American adults were former smokers, representing half of all people who had ever smoked. Physicians play a critical role in reducing the burden of tobacco-related health problems by helping their patients who smoke to quit and by motivating their nonsmoking patients to remain nonsmokers. Unfortunately, many physicians report inadequate training in smoking cessation, and many smokers who see physicians do not receive assistance to quit.
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