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Item Update on the approach to smoking in patients with respiratory diseases.(2019) Sales, Maria Penha Uchoa; Araújo, Alberto José de; Chatkin, José Miguel; Godoy, Irma de; Pereira, Luiz Fernando Ferreira; Castellano, Maria Vera Cruz de Oliveira; Minamoto, Suzana Erico Tanni; Almeida, Adriana Ávila de; Chatkin, Gustavo; Silva, Luiz Carlos Côrrea da Silva; Gonçalves, Cristina Maria Cantarino; Botelho, Clóvis; Santos, Ubiratan Paula; Viegas, Carlos Alberto de Assis; Sestelo, Maristela Rodrigues; Meireles, Ricardo Henrique Sampaio; Corrêa, Paulo César Rodrigues Pinto; Oliveira, Maria Eunice Moraes de; Reichert, Jonatas; Lima, Mariana Silva; Silva, Celso Antonio Rodrigues daSmoking is the leading cause of respiratory disease (RD). The harmful effects of smoking on the respiratory system begin in utero and influence immune responses throughout childhood and adult life. In comparison with “healthy” smokers, smokers with RD have peculiarities that can impede smoking cessation, such as a higher level of nicotine dependence; nicotine withdrawal; higher levels of exhaled carbon monoxide; low motivation and low self-efficacy; greater concern about weight gain; and a high prevalence of anxiety and depression. In addition, they require more intensive, prolonged treatment. It is always necessary to educate such individuals about the fact that quitting smoking is the only measure that will reduce the progression of RD and improve their quality of life, regardless of the duration and severity of the disease. Physicians should always offer smoking cessation treatment. Outpatient or inpatient smoking cessation treatment should be multidisciplinary, based on behavioral interventions and pharmacotherapy. It will thus be more effective and cost-effective, doubling the chances of success.