Smoking is known as one of the major cause of disability and premature death. It should be framed as an individual-level disease requiring medical treatment. Smoking is addictive disease characterized by compulsive drug seeking, and smokers needs therapeutic interventions such as nicotine replacement therapy and nicotine agonist. In terms of addiction, nicotine facilitating neurotransmitter release results in the development of nicotine dependence, and corticotropin-releasing factor related nicotine withdrawal. Smoking will be regarded as disease, for smoking cessation is more effective intervention to prevent mortality than hypertension and dyslipidemia treatment. We will review some aspects of framing tobacco as a disease, and move on to the recent American and Japanese guideline which encourage the social reimbursement system of cessation practice.