Overall Approach to Treatment
Nicotine dependence treatment targets severity of
the problem, co-occurring disorders and the different motivational levels to
change. Treatment is provided in a range of levels of intensity of care
(self-help, brief treatment and once or twice per week out-patient treatment)
and may include different modalities (self-help guides, internet resources,
medications and individual or group therapy). Formal treatment options have
expanded rapidly in the past 25 years to include six FDA-approved medications,
a range of effective psychosocial interventions including internet and
phone-line services. Unfortunately, most insurance plans do not cover nicotine
dependence treatment, and only some prescrip-tion plans will cover the
medications. Few individuals receive combined medications and therapy treatment.
Most receiving treatment get medication treatments, and only about 3% of the
individuals receiving medication treatments will also receive psychosocial
treatment despite the fact that this combination im-proves outcomes by 50%.
Primary care treatment providers tend to offer brief counseling treatment
services with follow-up visits. In addition, many individuals receive minimal
formal treatment and either purchase over-the-counter nicotine replacement
patch or gum, or go to Nicotine Anonymous or other self-help groups in
attempting to quit on their own.