title: Emerging drugs for the treatment of tobacco dependence: 2014 update.
abstract: BACKGROUND
  Tobacco dependence remains a global epidemic and the largest preventable cause of morbidity and mortality around the world. Smoking cessation has benefits at all ages but remains challenging for several reasons, among which are the complexities of nicotine addiction and limitations of available pharmacotherapies.
  
  
  METHODS
  This review summarizes current and emerging pharmacotherapies for the treatment of tobacco dependence, including first- and second-line recommended agents. Medications with alternative primary indications that have been investigated as potential treatments for tobacco dependence are also discussed. Articles reviewed were obtained through searches of PubMed, Ovid MEDLINE, ClinicalTrials.gov and the Pharmaprojects database.
  
  
  CONCLUSIONS
  Current evidence suggests that the two most effective pharmacotherapies to treat tobacco dependence are varenicline and combination nicotine replacement therapy. Alternative agents investigated demonstrate mixed rates of success in achieving long-term abstinence from smoking. No single pharmacotherapy will serve as a universally successful treatment given the complex underpinnings of tobacco dependence and individuality of smokers. The ultimate goal of tobacco research with respect to pharmacotherapeutic development continues to be providing clinicians with an armamentarium of drugs to choose from allowing for tailoring of treatment for smokers.
authors.affiliation: Mayo Clinic , 200 First Street Southwest, Rochester, MN 55905 , USA.
authors.forename: Muhamad Y
authors.initials: MY
authors.lastname: Elrashidi
authors.forename: Jon O
authors.initials: JO
authors.lastname: Ebbert
mesh_terms: D000069445:Atomoxetine Hydrochloride; D001552:Benzazepines / Q000627:therapeutic use; D016642:Bupropion / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003000:Clonidine / Q000627:therapeutic use; D006801:Humans; D008464:Mecamylamine / Q000627:therapeutic use; D009538:Nicotine / Q000627:therapeutic use; D009661:Nortriptyline / Q000627:therapeutic use; D011437:Propylamines / Q000627:therapeutic use; D011810:Quinoxalines / Q000627:therapeutic use; D061485:Tobacco Use Cessation Devices; D014029:Tobacco Use Disorder / Q000188:drug therapy*; D000068580:Varenicline
chemical_list: D001552:Benzazepines; D011437:Propylamines; D011810:Quinoxalines; D016642:Bupropion; D000069445:Atomoxetine Hydrochloride; D008464:Mecamylamine; D009538:Nicotine; D009661:Nortriptyline; D003000:Clonidine; D000068580:Varenicline
keywords: EVT 302; GSK598809; N-acetylcysteine; atomoxetine; baclofen; bupropion; buspirone; carvedilol; clonidine; cytisine; d-cycloserine; emerging pharmacotherapies; labetalol; lobeline; mecamylamine; naltrexone; nicotine replacement therapy; nicotinic acetylcholine receptors; nortriptyline; reboxetine; rimonabant; selegiline; silver acetate; smoking; smoking cessation/methods; smoking/drug therapy; surinabant; tiagabine; topiramate; varenicline; vigabatrin