Clini- cians, researchers, and policymakers alike must contin- ue to place cost-effective analyses in the proper context, extracting key value determinations while acknowledg- ing the challenges in fully characterizing and incorpo- rating the downstream benefits of a given therapeutic prevention tactic. Further research and methodological advances are needed to comprehensively characterize the full spectrum of benefits produced by the preven- tion approach, thereby rendering cost-effectiveness as- sessments more consequential to clinical practice. Most ASCVD events are avoidable through primordial prevention (ie, the prevention of risk factor develop- ment) and control of traditional cardiovascular risk factors. Tobacco avoidance is critically important for ASCVD prevention, and all adults should strive to en- gage in regular brisk physical activity most days of the Table 8. Highlights of Recommended Behavioral and Pharmacotherapy Tobacco Treatment Modalities for Prescribers* Timing of Behavioral Interventions <3 min of tobacco status assessment with cessation counseling at each clinic encounter >3-10 min of tobacco status assessment with cessation counseling at each clinic encounter >10 min of tobacco status assessment with cessation counseling at each clinic encounter Treatment Dosing Precautions NRT* Patch 21 mg, 14 mg, or Starting dose: 21 mg for 10 CPD; 14 mg for <10 CPD Local irritation possible; avoid with skin disorders; may remove for sleep if needed Gum 2 mg or 4 mg Starting dose: 4 mg if first tobacco use is 30 min after waking; 2 mg if first tobacco use is >30 min after waking; maximum of 20 lozenges or 24 pieces of gum/d. 