Pharmacotherapy for Nicotine Dependence

Pharmacotherapies for smoking reduction and cessation can play a vital role in helping individuals quit smoking. This article summarizes the current rates of smoking and smoking-related disease in the United States, outlines the projected benefits of tobacco use reduction and cessation, and presents the rationale for use of pharmacotherapies to treat tobacco dependence. The authors then describe existing pharmacotherapies, combination therapies, long-term medication therapies and harm reduction strategies.

Key Findings:

  • Existing pharmacotherapies for smoking cessation include nicotine replacement medications in the form of gum, transdermal patch, lozenge, sublingual tablet, nasal spray and vapor inhaler formulations.
  • Non-nicotine medication therapies currently in use or under development include bupropion, nortriptyline, clonidine, rimonabant, varenicline and nicotine vaccines.
  • A number of improvements might increase the efficacy of nicotine replacement therapy (NRT) such as increasing dose, increasing the delivery speed (faster release gums), the creation of a true pulmonary inhaler to replace the current oral absorption inhaler and the use of tailored combinations of cessation products to fight cravings as well as long-term withdrawal symptoms.