Case 6: John
John, a fit man in his 20s, attended an initial appointment with his new primary care physician, during which time his prior military history came to light. John recalled the anxiety he experienced when he received his military orders for deployment to Iraq. Prior to the notice of deployment, he smoked cigarettes only occasionally, maybe 1 or 2 cigarettes a day. As the time for deployment approached, he started smoking more cigarettes and by the time he arrived in Iraq was up to a full pack a day. Throughout the 12-month deployment, he steadily increased his smoking with peak consumption of nearly 40 cigarettes a day. John suffered several significant combat-related traumas resulting in mild physical injuries.
Upon return to the United States, John completed his military obligation and left the service. Although still experiencing some lingering physical and emotional pain from his tour of duty, he felt he was improving except in one area – his use of tobacco products stubbornly persisted, despite efforts to quit. The 2 packs of cigarettes a day was not only expensive, it was no longer enjoyable. When questioned, John admitted that only the first cigarette of the day was truly enjoyable. In addition, John’s wife was complaining that the expensive habit was creating an unnecessary financial strain on their meager resources.
Despite his apparent willingness to consider quitting the use of tobacco, John readily admitted he was frightened by the prospect. He recognized that his unresolved emotional issues from the war offered a reason not to tackle another problem at this time. The doctor asked John to consider a smoking cessation program, which John agreed to do. They scheduled a follow-up appointment in 2 weeks.
The article must be evidence-based - meaning it is a report of findings arising from experimental research conducted by the article author[s] and not opinion articles or publications summarizing multiple research studies - peer-reviewed, and retrieved from the APUS online library.
You must attach your bibliography document as well as PDFs of the articles you are reviewing in the assignment tab.

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The case study of John provides an interesting example of tobacco addiction. John has progressed from smoking a few times a day to smoking two packs daily and this has created considerable stress in his personal and romantic life. While this started as a recreational habit, it has evolved into an addiction that is no longer enjoyable and yet cannot be maintained indefinitely. This is complicated by John’s physical and mental wounds from war, which create additional stress that likely impact his ability to quit smoking. Ultimately, John needs to find some way to kick his habit. This will relate to his desire to quit as well as potential tools for quitting. The annotated bibliography will explore the various treatments for tobacco use ranging from self-help to psychotherapy to psychopharmacology. In John’s case, there are a range of potential treatments available and he may need to explore and utilize all of them. In general, he will have some trouble beating his tobacco addiction but it can be done, especially with all the treatment advances currently available for treatment of tobacco dependence.
Culbertson, C. S., Bramen, J., Cohen, M. S., London, E. D., Olmstead, R. E., Gan, J. J., Costello, M. R., Shulenburger, S., Mandelkern, M. A., & Brody, A. L. (2011). Archives of General Psychiatry, 68(5), 505-515. doi: 10.1001/archgenpsychiatry.2010.193
Many different pharmacological treatments have been focused on nicotine replacement but usually this is implemented through means that are not similar to smoking. The electronic cigarette is an interesting new device that administers nicotine through inhalation much like a cigarette but does so without the same carcinogens that are commonly found in cigarettes. The purpose of this study was to determine if this alternative could be used to decrease or even replace cigarette smoking. To do this 40 habitual smokers were given the electronic cigarette for daily consumption over a six month period and required to keep a regular journal of their use of electronic and traditional cigarettes. While the majority of participants continue smoking regular and electronic cigarettes, there was a considerable reduction in the number of traditional cigarettes smoked. In addition, most of the smokers found these alternative cigarettes to be acceptable replacements and continued to use the electronic cigarettes for the duration of...

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