Previous research has demonstrated that individuals who are severely addicted to cigarettes may have more difficulty quitting, higher rates of relapse and greater risk of smoking-related diseases than lighter smokers. The effectiveness of current tobacco dependence treatment for severe addiction is less well-known. This paper comments on findings from Saul Shiffman, Ph.D., and colleagues on the efficacy of medicinal nicotine therapy. Data from two placebo-controlled studies were reanalyzed to assess the impact of nicotine patch and lozenge therapy comparing very heavy or highly-dependent smokers with lighter or less-dependent smokers. Study participants also received intensive behavioral therapy. Results may have broader application to other forms of addiction and addiction treatment.