Cigarette smoking is the single most preventable cause of premature mo
rtality in this country. Fortunately, there are both behavioral and ph
armacological approaches that are effective in long-term smoking cessa
tion. The purpose of this review will be first to highlight the short-
and long-term effectiveness of behavioral, pharmacological, and combi
ned approaches to smoking cessation. We will review what is known abou
t the mechanisms of change in both behavioral and pharmacological trea
tments. Adherence to both approaches will be highlighted and cost-effe
ctiveness issues will be discussed. It will be concluded that despite
the relatively high cost per confirmed long-term quit smoker, smoking
cessation is an area in which a high degree of cost effectiveness can
be demonstrated. Copyright (C) 1996 Elsevier Science Ltd