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.