Clear evidence-based clinical practice guidelines are available for smoking cessation treatment in the general population of smokers, recommending both behavioral counseling and pharmacotherapy, including nicotine replacement therapy and bupropion therapy.9 But, despite the fact that smoking cessation is the only evidence-based intervention for treating COPD,8 surprisingly little is known about the effectiveness of these evidence-based interventions in COPD patients. Reviews10–11 from the past few years identified only five randomized controlled trials and concluded that a combination of pharmacotherapy with intensive individual counseling over an extended period of time appears to be effective for treating patients with COPD. However, many gaps exist in our understanding of how best to help COPD patients stop smoking. First, although guidelines for COPD (eg, American Thoracic Society12) recommend the use of existing behavioral and pharmacologic smoking cessation therapies, the preliminary data suggest that smokers with COPD may have a different pattern of smoking than those without COPD (eg, greater nicotine dependence, heavier smoking, and higher CO concentrations in expired air).13 Therefore, it remains unclear whether smokers with COPD are comparable to healthy smokers in their response to existing interventions. Second, we do not know how quit rates compare in patients with varying degrees of COPD severity. In one study,14 prolonged abstinence rates were lower in patients with more severe COPD (stage II) compared to patients with stage I COPD, but this difference was not statistically significant. Third, no conclusions could be drawn regarding the effectiveness of behavioral intervention alone due to the lack of high-quality studies comparing such interventions with placebo or no treatment control conditions.