Treatment of Tobacco Use Recommendations for Treatment of Tobacco Use Referenced studies that support recommendations are summarized in Online Data Supplements 15 and 16. COR LOE Recommendations I A All adults should be assessed at every healthcare visit for tobacco use and their tobacco use status recorded as a vital sign to facilitate tobacco cessation.S4.5-1 I A To achieve tobacco abstinence, all adults who use tobacco should be firmly advised CLINICAL STATEMENTS AND GUIDELINES I A In adults who use tobacco, a combination of behavioral interventions plus pharmacotherapy is recommended to maximize quit rates.S4.5-2,S4.5-3 I B-NR In adults who use tobacco, tobacco abstinence is recommended to reduce IIa B-R To facilitate tobacco cessation, it is reasonable to dedicate trained staff to tobacco treatment in every healthcare III: Harm B-NR All adults and adolescents should avoid secondhand smoke exposure to reduce Synopsis Tobacco use is the leading preventable cause of disease, disability, and death in the United States.S4.5-7 Smoking and smokeless tobacco (eg, chewing tobacco) use in- creases the risk of all-cause mortality and is a cause Secondhand smoke is a cause of ASCVD and stroke,S4.5-6 and almost one-third of CHD deaths are attributable to smoking and exposure to secondhand smoke. 