Tobacco use is the single most important preventable health risk in the developed world, and an important cause of premature death worldwide. Smoking causes a wide range of diseases, including many types of cancer, chronic obstructive pulmonary disease, coronary heart disease, stroke, peripheral vascular disease, and peptic ulcer, while it also affects fetal and neonatal growth and development. Many of the adverse health effects of smoking are reversible, and smoking cessation treatments represent some of the most cost effective of all health care interventions. In order to improve smoking cessation rates effective behavioral and pharmacological treatments, together with professional counseling and advice are required. Since smoking duration is the major risk factor for smoking - related morbidity the treatment goal should be early cessation and prevention of relapse. Nowadays, guidelines from national and worldwide medical organizations promote treatment for tobacco dependence. Pharmacological treatment is an essential cornerstone of treatment for tobacco dependence. Nicotine replacement therapy and sustained released bupropion are recommended as first line treatment in the updated guidelines, in conjunction with behavioral intervention for the management of smoking cessation. Pneumon 2005, 18(3):245-262.