Tobacco Addiction

A 58-year-old woman with chronic obstructive pulmonary disease, type 2 diabetes, hypertension, and a history of major depression that is currently in remission presents with a 45-pack-year history of smoking. She smokes 25 cigarettes per day, with her first cigarette smoked within 5 minutes after waking. She has been unable to quit smoking with the regular use of nicotine gum for 4 weeks. Her current medications include fluticasone-salmeterol, ramipril, metformin, empagliflozin, venlafaxine, and, as needed, albuterol. How should her tobacco addiction be treated?

Automated summary

A 58-year-old female smoker with multiple comorbidities and a history of major depression seeks treatment for smoking cessation. Despite using nicotine gum for 4 weeks continuously, she has been unable to quit smoking.