Strategies to help smokers who are resistant to treatment include intensive combination pharmacotherapies and the use of nicotine replacement therapy to reduce the harm caused by smoking.
- There is a hierarchy of strategies available to help tobacco smokers that begins with permanent cessation and provides safe options for those people unable to achieve this.
- Some smokers respond well to some pharmacotherapies and others do not. Every smoking cessation pharmacotherapy for which there is substantiated evidence should be tried – a patient just might strike the most suitable one for them.
- The harm reduction strategy of reducing smoking by the use of nicotine replacement therapy (NRT) should be considered for treatment-resistant smokers. It is less harmful for a person to smoke while using NRT than it is to smoke without it.
- There is good evidence that it is never too late to quit smoking. Reducing smoking by the transient use of NRT may be a gateway to quitting for treatment-resistant smokers.
- Algorithms are provided for smoking cessation therapy options and the use of combination NRT in treatment-resistant smokers.