An update on the pharmacotherapeutic interventions for smoking cessation.
BACKGROUND
Cigarette smoking can damage every organ in the body and is the leading known preventable cause of death globally. It is estimated that 70% of patients want to quit, and about 50% report a quit attempt in the past year, yet only 4-7% are successful. These low quit rates represent the importance of appropriate treatment for smoking cessation through behavioral and pharmacotherapeutic means.


METHODS
Pharmacotherapy approximately doubles patients' chances of quitting, and the first-line approved pharmacotherapetuic options include nicotine gum, lozenge, patch, nasal spray, and inhaler, sustained-release bupropion, and varenicline. Second-line therapies include nortriptyline and clonidine. Recent evidence suggests a potential role for cytisine and naltrexone. Healthcare providers play an important role in helping patients quit smoking; therefore, a clear understanding of appropriate dosing, regimen, technique, disadvantages, advantages, warnings/precautions, and contraindications for available pharmacotherapeutic options is essential.


CONCLUSIONS
To improve chances of success, providers should consider patient preferences and prior experiences with quitting, provide medication-specific counseling for the selected therapy, and encourage adherence with the behavioral and pharmacotherapeutic treatment regimen.
a Pharmacotherapeutics and Clinical Research , University of South Florida College of Pharmacy , Tampa , FL , USA.
Jose L
JL
Barboza
a Pharmacotherapeutics and Clinical Research , University of South Florida College of Pharmacy , Tampa , FL , USA.
Radha
R
Patel
a Pharmacotherapeutics and Clinical Research , University of South Florida College of Pharmacy , Tampa , FL , USA.
Pooja
P
Patel
b Department of Pharmacy Practice , Purdue University College of Pharmacy , Indianapolis , IN , USA.
Karen Suchanek
KS
Hudmon
D001552:Benzazepines / Q000008:administration & dosage; D016642:Bupropion / Q000008:administration & dosage; D016503:Drug Delivery Systems / Q000379:methods* / Q000523:psychology / Q000639:trends; D006801:Humans; D009538:Nicotine / Q000008:administration & dosage; D018722:Nicotinic Agonists / Q000008:administration & dosage; D012907:Smoking / Q000188:drug therapy* / Q000523:psychology; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology; D061485:Tobacco Use Cessation Devices / Q000639:trends
D001552:Benzazepines; D018722:Nicotinic Agonists; D016642:Bupropion; D009538:Nicotine
Smoking cessation; bupropion; nicotine gum; nicotine inhaler; nicotine lozenge; nicotine nasal spray; nicotine patch; nicotine replacement therapy; tobacco cessation; varenicline