There is compelling evidence that abstinence from smoking is important in the prevention and management of pulmonary and cardiovascular disease. The most favorable results of smoking cessation will be obtained in persons at high risk for a smoking-related disease in persons who already have manifestations of that disease. Both the physician and patient realize the urgency of smoking cessation, and it is relatively easy to motivate the patient to cooperate in a program designed to produce abstinence.
Because of the relationship of cigarette smoking to the development of chronic obstructive lung disease (COLD), most physicians recommend cessation of smoking to patients with symptoms of COLD. Unfortunately, abstinence from cigarettes may not prevent death in these patients because the disease is far advanced. Every effort should be made to induce the patient to stop smoking before he is severely incapacitated. Symptomatic COLD occurs most commonly in persons who have smoked heavily