Use of an algorithm of this type confirms two important points: (1) individualizing and tailoring medication combinations and doses, similar to the current asthma standard-of-care, improves tobacco dependence treatment effectiveness. Essentially every published study heretofore found that treatment effectiveness was inversely proportional to the number of cigarettes smoked per day. The worst smoking cessation rates were seen in those who, pretreatment, had smoked > 20 cigarettes per day. Moreover, the number of cigarettes smoked per day, pretreatment, inversely predicted the percentage not smoking at any time after treatment start. Dale et al15 found this relationship highly significant (p < 0.0001) across all doses of sustained-release bupropion studied. Table 115 shows that 33% of patients randomized to placebo who had smoked ≤ 19 cigarettes per day had stopped smoking at the end of study drug treatment, while only 4% who had smoked ≥ 40 cigarettes per day could stop. Figure 4 in the study by Bars et al1 demonstrates that the novel approach eliminates that inverse relationship. At 3 months, approximately 50% of those who had smoked 6 to 19 cigarettes per day had stopped, as had approximately 50% who had smoked > 40 cigarettes per day. Even more remarkable, at the 12-month evaluation point,1 9 months after all treatment had stopped, treatment effectiveness was directly proportional to the pretreatment number of cigarettes per day: approximately 30% of those who had smoked 6 to 19 cigarettes per day had stopped, but nearly twice that (approximately 50%) who had smoked > 40 cigarettes per day had stopped. This finding is truly remarkable and without precedent. If subsequent, randomized, double-blind studies confirm the unique, individualized approach of Bars et al,1 we will be able to safely provide far more effective tobacco dependence treatment for the patients in our office.