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Richard S. Merrick, MD
Kaiser Permanente Chemical Dependency Recovery Program Carson, Calif

JAMA. 1996;276(6):448.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—The Agency for Health Care Policy and Research (AHCPR) Smoking Cessation Clinical Practice Guideline¹ presents useful strategies for some patients with nicotine addiction. The low quit rates typically achieved by this approach reflect a failure to recognize that a majority of nicotine-dependent patients require more intensive therapy.

Even the recommendations regarding intensive cessation programs are not sufficient in intensity or duration for most smokers. Would anyone ever consider such a minimalist approach to other addictions such as alcohol, cocaine, or heroin?

These guidelines trivialize nicotine addiction. I propose future guidelines incorporate an addiction-model treatment approach to this most significant problem and include greatly expanded intensity and duration of treatment. . . . [Full Text PDF of this Article]

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