Over the past two decades, the management of addictions by general practitioners has evolved significantly, not only in the area of tobacco use but also in alcohol dependence and problems related to the use of other psychoactive substances. In the realm of illicit drugs, authorities have gradually adopted a harm reduction policy since the late 1980s. At the same time, the rise of a new discipline in the late 1990s—addictology—along with the creation of a Diploma of Specialized Complementary Studies (DESC) and numerous university diplomas (DU) and certifications, helped establish tobacco and alcohol as key psychoactive substances requiring specific treatment approaches. The introduction of addiction studies also changed the way addictions are approached from a public health perspective, emphasizing the need to develop a two-stage care model to accommodate users with diverse profiles: early identification of risky use (particularly through general practitioners) followed, if necessary, by referral to a specialized facility. The idea that simply asking about psychoactive substance use during a consultation has preventive effects has since been widely adopted to expand, consolidate, and diversify healthcare services. A national program to develop tobacco counseling services was thus implemented between 2000 and 2002. The development of an approach focused on behaviors rather than on products has more recently led to the establishment of centers for addiction care, support, and prevention (Csapa), which now replace the specialized treatment centers for drug addicts (CSST) and the outpatient alcohol treatment centers (CCAA).[chapter excerpt]