[Preventive relapse treatment for tobacco cessation - is it worthwhile?].
Though different treatment modalities currently exist for tobacco cessation, many smokers still relapse following an initially successful quitting attempt. We herein provide a selected overview of tobacco relapse prevention strategies evaluated in different trials and in a recent meta-analysis. Most studies were characterised by an inadequate study design and insufficient numbers of participants. Randomised studies, both in selected (hospitalisation, pregnancy, military conscripts) and in unselected smoker groups showed no advantage of psychological interventions, mainly behavioural skills-based approaches. This was independent of whether smokers had been enrolled prior or after quitting tobacco. Pharmacological trials identified no benefit of preventive interventions with nicotine replacement treatments or Bupropion, but one study with prolonged Varenicline treatment significantly reduced the rate of relapse. Currently there is insufficient evidence to recommend systematic preventive relapse treatment for tobacco addiction with psychological or pharmacological interventions. Extended treatment with Varenicline may reduce relapse rates following tobacco cessation. Further meticulously designed and appropriately powered trials will be necessary to clarify the role of alternative psychological and pharmacological strategies for the prevention of relapse after tobacco cessation.
von Garnier
Christophe
C
Universitätsklinik für Pneumologie, Inselspital, Bern. christophe.vongarnier@insel.ch
D000928:Antidepressive Agents / Q000008:administration & dosage; D001521:Behavior Therapy; D001552:Benzazepines / Q000008:administration & dosage; D016642:Bupropion / Q000008:administration & dosage; D006801:Humans; D009538:Nicotine / Q000008:administration & dosage; D018722:Nicotinic Agonists / Q000008:administration & dosage; D011810:Quinoxalines / Q000008:administration & dosage; D016032:Randomized Controlled Trials as Topic; D055502:Secondary Prevention; D016540:Smoking Cessation / Q000379:methods*; D016896:Treatment Outcome; D000068580:Varenicline
D000928:Antidepressive Agents; D001552:Benzazepines; D018722:Nicotinic Agonists; D011810:Quinoxalines; D016642:Bupropion; D009538:Nicotine; D000068580:Varenicline