Which of the following is/are true regarding smoking cessation programs?

a. Since the time of the first Surgeon General’s report the prevalence of smoking among adults decreased from 40% to 29%

b. Using smoking cessation strategies initial success rates are approximately 45%, however, recidivism rates average 40–50%

c. Pharmacologic interventions combined with behavioral counseling increase the likelihood of long term abstinence from smoking

d. Quitting smoking even after prolonged use has beneficial effects on the outcome of peripheral vascular disease

Smoke is a complex substance with more than 2,000 recognized constituents and smoking addiction is a complex behavior. The initial Surgeon General’s report and subsequent efforts have resulted in a substantial decrease in the prevalence of smoking among adults. More than 90% of current smokers state that they would like to stop smoking. Initial success with smoking cessation programs averages 45%, however, the rate of recidivism is high (approximately 50%). Combined pharmacologic and behavioral modification strategies seem to have the best long term results. There is overwhelming evidence that cessation of smoking produces beneficial effects on any outcome measure for peripheral vascular disease. Improvement in claudication distance, avoidance of rest pain, more favorable outcome after arterial reconstructions, a reduced risk of stroke and a decrease in the rate of progression of carotid artery plaque has been demonstrated in those who stop smoking.