Developments in pharmacotherapy for tobacco dependence: past, present and future.
In the mid-1970s there were no effective pharmacological treatments for tobacco dependence. The invention of nicotine gum was a major treatment advance and also greatly helped our understanding of the nature of tobacco dependence. There are now eight effective pharmacotherapies (nicotine gum, patch, nasal spray, inhaler, lozenge/tablet, bupropion, nortriptyline and clonidine) available to aid smoking cessation. Other non-nicotine agents that show promise are under investigation, including glucose, rimonabant, selegiline and varenicline. Greater knowledge of the mechanisms of action of the effective non-nicotine agents should lead to better understanding of the nature of tobacco dependence. Future research into optimal treatments should examine long-term combination pharmacotherapy combined with improved psychosocial support that is partly designed to enhance medication compliance. In addition, there is a need for studies designed to evaluate the efficacy of pharmacotherapies in populations such as youth, pregnant smokers and smokers with co-occurring mental health problems.
Foulds
Jonathan
J
University of Medicine and Dentistry of New Jersey, School of Public Health, Tobacco Dependence Program, New Brunswick 08852, USA. jonathan.foulds@umdnj.edu
Steinberg
Michael B
MB
Williams
Jill M
JM
Ziedonis
Douglas M
DM
D000293:Adolescent; D000328:Adult; D016642:Bupropion / Q000008:administration & dosage*; D002986:Clinical Trials as Topic; D003000:Clonidine / Q000008:administration & dosage*; D004333:Drug Administration Routes; D005260:Female; D006801:Humans; D008297:Male; D009538:Nicotine / Q000008:administration & dosage*; D018722:Nicotinic Agonists / Q000008:administration & dosage*; D009661:Nortriptyline / Q000008:administration & dosage*; D011247:Pregnancy; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D016896:Treatment Outcome
D018722:Nicotinic Agonists; D016642:Bupropion; D009538:Nicotine; D009661:Nortriptyline; D003000:Clonidine