Problem/Objective: To quantify use of treatment in stopping smoking Methods: We searched for studies of the prevalence or incidence of use of a treatment for smoking cessation published in the last 20 yrs. We located 19 studies completed in the US (14 studies), Australia (2 studies), United Kingdom (2 studies) and New Zealand (1 study). Results: Among all current smokers, 11-21% had ever used a formal psychosocial treatment and 40-57% had ever used a medication to stop smoking. Among smokers who tried to quit in the last year, 1-7% had used a psychosocial treatment and 10-22% had used a medication when they tried to quit. These results suggest that contrary to the belief that almost all smokers quit on their own, in the developed countries the use of medications is becoming quite prevalent. On the other hand, our VT state surveys indicate that even among smokers who know about a free quitline, free group treatment and free individual counseling, < 5% will use any of these when they try to stop. We present our qualitative research that identifies disbelief of efficacy, embarrassment, lack of perceived need, lack of tailoring, and stigma as possible barriers to seeking psychosocial treatment. Conclusions: Tobacco control program services need to accommodate the demand for medication treatment and to increase the lack of demand for psychosocial treatments.