Most smokers do want to quit smoking. That this is not always an easy task can be attributed to the fact that dependence plays an important role. Nicotine dependence meets all criteria of addiction. The use is compulsive, it is hard to quit even when there is clear damage, withdrawal symptoms appear when stopping, and there is always a risk of falling back when trying to quit a chronic behavior. Smoking dependence fits the criteria given in the Diagnostic and Statistical Manual of Mental Disorders system, version IV (DSM IV),1 grading dependence and addiction to a substance (Table 28-1).