Smoking is a major health risk factor contributing to substantial morbidity and mortality worldwide. Although most smokers express a desire to quit— or they attempt to do so—, achieving smoking cessation solely through individual willpower is often challenging. Primary care plays a pivotal role in supporting smoking cessation efforts by increasing the likelihood of success. Even brief advice from a physician significantly increases the chance of quitting, and combining counseling with pharmacotherapy further improves cessation rates. Particular attention is required for smokers in special populations, such as those with cardiovascular diseases or mental health conditions, wherein tailored and proactive smoking cessation interventions are crucial. Digital health tools, including smartphone applications and text messaging interventions, have recently emerged as effective strategies to support personalized smoking cessation behaviors. Furthermore, institutional support, such as national programs, quitlines, and post-screening counseling for lung cancer, are critical resources that promote successful cessation. Primary care physicians are uniquely positioned to foster longterm smoking cessation success through sustained relationships with patients by leveraging these tools and resources to provide comprehensive and continuous care.

Smoking is a major health risk factor contributing to substantial morbidity and mortality worldwide. Although most smokers express a desire to quit— or they attempt to do so—, achieving smoking cessation solely through individual willpower is often challenging. Primary care plays a pivotal role in supporting smoking cessation efforts by increasing the likelihood of success. Even brief advice from a physician significantly increases the chance of quitting, and combining counseling with pharmacotherapy further improves cessation rates. Particular attention is required for smokers in special populations, such as those with cardiovascular diseases or mental health conditions, wherein tailored and proactive smoking cessation interventions are crucial. Digital health tools, including smartphone applications and text messaging interventions, have recently emerged as effective strategies to support personalized smoking cessation behaviors. Furthermore, institutional support, such as national programs, quitlines, and post-screening counseling for lung cancer, are critical resources that promote successful cessation. Primary care physicians are uniquely positioned to foster longterm smoking cessation success through sustained relationships with patients by leveraging these tools and resources to provide comprehensive and continuous care.

Smoking is a major health risk factor contributing to substantial morbidity and mortality worldwide. Although most smokers express a desire to quit— or they attempt to do so—, achieving smoking cessation solely through individual willpower is often challenging. Primary care plays a pivotal role in supporting smoking cessation efforts by increasing the likelihood of success. Even brief advice from a physician significantly increases the chance of quitting, and combining counseling with pharmacotherapy further improves cessation rates. Particular attention is required for smokers in special populations, such as those with cardiovascular diseases or mental health conditions, wherein tailored and proactive smoking cessation interventions are crucial. Digital health tools, including smartphone applications and text messaging interventions, have recently emerged as effective strategies to support personalized smoking cessation behaviors. Furthermore, institutional support, such as national programs, quitlines, and post-screening counseling for lung cancer, are critical resources that promote successful cessation. Primary care physicians are uniquely positioned to foster longterm smoking cessation success through sustained relationships with patients by leveraging these tools and resources to provide comprehensive and continuous care.

Smoking is a major health risk factor contributing to substantial morbidity and mortality worldwide. Although most smokers express a desire to quit— or they attempt to do so—, achieving smoking cessation solely through individual willpower is often challenging. Primary care plays a pivotal role in supporting smoking cessation efforts by increasing the likelihood of success. Even brief advice from a physician significantly increases the chance of quitting, and combining counseling with pharmacotherapy further improves cessation rates. Particular attention is required for smokers in special populations, such as those with cardiovascular diseases or mental health conditions, wherein tailored and proactive smoking cessation interventions are crucial. Digital health tools, including smartphone applications and text messaging interventions, have recently emerged as effective strategies to support personalized smoking cessation behaviors. Furthermore, institutional support, such as national programs, quitlines, and post-screening counseling for lung cancer, are critical resources that promote successful cessation. Primary care physicians are uniquely positioned to foster longterm smoking cessation success through sustained relationships with patients by leveraging these tools and resources to provide comprehensive and continuous care.

Cigarette smoking is the leading preventable cause of death, with smoking cessation representing the most effective strategy to reduce the risk of smoking-related diseases. Pharmacotherapeutic interventions for smoking cessation such as nicotine replacement therapy, bupropion, and varenicline aim to manage the symptoms of nicotine cravings and withdrawal. Evidence-based practice guidelines for pharmacotherapy in smoking cessation have been recently developed in Korea.Current Concepts: Among the general population, varenicline is the recommended first-line therapy for smoking cessation, surpassing nicotine patches and bupropion therapy. Although varenicline is commonly effective, combination therapy with varenicline and a nicotine patches may be considered when varenicline monotherapy is insufficient for managing nicotine cravings and withdrawal symptoms. Extended-duration therapy (>12 weeks) has demonstrated greater efficacy compared to standard therapy (6-12 weeks). Varenicline can promote attempts to quit smoking in smokers who are not yet prepared to quit. In cases of smokers with comorbid psychiatric conditions, varenicline is preferred over nicotine patches. The efficacy and safety profiles of smoking cessation medications have been well established in patients with cardiovascular diseases.Discussion and Conclusion: Smoking is a chronic condition associated with a high risk of relapse, emphasizing the crucial role of pharmacotherapy in increasing the success rates of smoking cessation. In accordance with evidence-based smoking cessation guidelines, the careful selection of pharmacotherapeutic agents tailored to individual smokers is pivotal.

Although major countries, such as South Korea, have developed and disseminated national smoking cessation guidelines, these efforts have been limited to developing individual societies or specialized institution-based recommendations. Therefore, evidence-based clinical guidelines are essential for developing smoking cessation interventions and promoting effective smoking cessation treatments. This guideline targets frontline clinical practitioners involved in a smoking cessation treatment support program implemented in 2015 with the support of the National Health Insurance Service. The Guideline Development Group of 10 multidisciplinary smoking cessation experts employed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE)-ADOLOPMENT approach to review recent domestic and international research and guidelines and to determine evidence levels using the GRADE methodology. The guideline panel formulated six strong recommendations and one conditional recommendation regarding pharmacotherapy choices among general and special populations (mental disorders and chronic obstructive lung disease [COPD]). Strong recommendations favor varenicline rather than a nicotine patch or bupropion, using varenicline even if they are not ready to quit, using extended pharmacotherapy (>12 weeks) rather than standard treatment (8–12 weeks), or using pharmacotherapy for individuals with mental disorders or COPD. The conditional recommendation suggests combining varenicline with a nicotine patch instead of using varenicline alone. Aligned with the Korean Society of Medicine’s clinical guideline development process, this is South Korea’s first domestic smoking cessation treatment guideline that follows standardized guidelines. Primarily focusing on pharmacotherapy, it can serve as a foundation for comprehensive future smoking cessation clinical guidelines, encompassing broader treatment topics beyond medications.

The Korean Society for Electrolyte and Blood Pressure Research, in collaboration with the Korean Society of Nephrology, has published a clinical practice guideline (CPG) document for hyponatremia treatment. The document is based on an extensive evidence-based review of the diagnosis, evaluation, and treatment of hyponatremia with the multidisciplinary participation of representative experts in hyponatremia with methodologist support for guideline development. This CPG consists of 12 recommendations (two for diagnosis, eight for treatment, and two for special situations) based on eight detailed topics and nine key questions. Each recommendation begins with statements graded by the strength of the recommendations and the quality of the evidence. Each statement is followed by rationale supporting the recommendations. The committee issued conditional recommendations in favor of rapid intermittent bolus administration of hypertonic saline in severe hyponatremia, the use of vasopressin receptor antagonists in heart failure with hypervolemic hyponatremia, and syndrome of inappropriate antidiuresis with moderate to severe hyponatremia, the individualization of desmopressin use, and strong recommendation on the administration of isotonic fluids as maintenance fluid therapy in hospitalized pediatric patients. We hope that this CPG will provide useful recommendations in practice, with the aim of providing clinical support for shared decision-making to improve patient outcomes.

The Korean Society for Electrolyte and Blood Pressure Research, in collaboration with the Korean Society of Nephrology, has published a clinical practice guideline (CPG) document for hyponatremia treatment. The document is based on an extensive evidence-based review of the diagnosis, evaluation, and treatment of hyponatremia with the multidisciplinary participation of representative experts in hyponatremia with methodologist support for guideline development. This CPG consists of 12 recommendations (two for diagnosis, eight for treatment, and two for special situations) based on eight detailed topics and nine key questions. Each recommendation begins with statements graded by the strength of the recommendations and the quality of the evidence. Each statement is followed by rationale supporting the recommendations. The committee issued conditional recommendations in favor of rapid intermittent bolus administration of hypertonic saline in severe hyponatremia, the use of vasopressin receptor antagonists in heart failure with hypervolemic hyponatremia, and syndrome of inappropriate antidiuresis with moderate to severe hyponatremia, the individualization of desmopressin use, and strong recommendation on the administration of isotonic fluids as maintenance fluid therapy in hospitalized pediatric patients. We hope that this CPG will provide useful recommendations in practice, with the aim of providing clinical support for shared decision-making to improve patient outcomes.