There are multiple challenges to the clinical treatment of tobacco dependence. Many clinicians do not consistently offer cessation treatments to their patients who smoke15, only about 20% of smokers are ready to make a quit attempt at any point in time16, and smokers too infrequently use evidence based treatments. Consequently, about 95% of unaided quit attempts end in failure17. Finally, non-adherence to medications and counseling is common and reduces cessation success18,19. Patients typically take only about 50% of their recommended medication doses18, and often complete less than half of scheduled counseling sessions19.
