The current practice of treating smokers as a homogenous group fails to recognise and adequately address the vast range (10–80ng/mL) of nicotine plasma levels (Russell, 1990) found among smokers. The Bittoun Model (Bittoun, 2006) individualises treatment according to the level of nicotine dependency. A total of 115 participants were enrolled in a 12-month program review based on the Bittoun Combination Nicotine Replacement Therapy (NRT) Algorithm (Bittoun, 2006). Participants found to be non nicotine dependent (Fagerstrom Test for Nicotine Dependence [FTND] = 0) (Heatherton et al., 1991) were excluded from the study. At 3 months, 52% (n = 99) of participants were total abstainers (self-reporting and expired CO ≤ 5ppm). Outcomes at 6 months (n = 58) and 12 months (n = 18; self-reporting) were 48% and 33% respectively. The Bittoun Model of Smoking Cessation offers an efficacious strategy for the assessment, management and delivery of tobacco intervention for the hard to treat smoker.