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Advances in Non-Nicotine Pharmacotherapy for Smoking Cessation

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Abstract

Progress in understanding the pharmacological nature of tobacco addiction, along with the modest success rates achieved by the nicotine replacement therapies, has provided the major impetus for the development of non-nicotine drugs as smoking cessation aids. This article reviews evidence from controlled trials of several non-nicotine medications for the treatment of nicotine dependence.

Clonidine was the first non-nicotine medication to show efficacy for smoking cessation in multiple studies, but its effect was found to be limited at best. Positive results across several trials have been consistently demonstrated for amfebutamone (bupropion). Encouraging results have also been observed for nortriptyline and moclobemide. Studies of combined treatments using non-nicotine medications (amfebutamone, mecamylamine, oral dextrose) with nicotine replacement therapy suggest increased efficacy relative to treatments using one or the other treatment strategy alone.

Thus, available evidence indicates that non-nicotine drug treatments offer a promising panoply of therapeutic strategies for the addicted smoker.

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Acknowledgements

Parts of the sections on clonidine, buspirone and amfebutamone may be found in Johnston JA, Robinson MD, Adams DP, Glassman AH, Covey LS, ‘Nonnicotine medications for smoking cessation’, Chapter 8, pp. 159-173 in (Eds. D.F. Seidman, L.S. Covey), Helping the Hard-core Smoker, New Jersey: Lawrence Erlbaum Associates, Inc., 1999.

The authors thank Shara Feldman B.A. for her assistance, and reviewers of an earlier version of this paper for their helpful comments.

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Authors and Affiliations

  1. New York State Psychiatric Institute, 1051 Riverside Drive, New York, New York, 10032, USA

    Lirio S. Covey, Maria A. Sullivan & Alexander H. Glassman

  2. Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York, USA

    Lirio S. Covey, Maria A. Sullivan & Alexander H. Glassman

  3. Glaxo-Wellcome Inc., Five Moore Drive, Research Triangle Park, North Carolina, USA

    J. Andrew Johnston

  4. Cabarrus Family Medicine Residency Program, Concord, North Carolina, USA

    Mark D. Robinson

  5. Department of Family Medicine and Public Health, James Quillen School of Medicine, East Tennessee State University, Johnson City, Tennessee, USA

    David P. Adams

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  1. Lirio S. Covey
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  2. Maria A. Sullivan
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Correspondence to Lirio S. Covey.

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Covey, L.S., Sullivan, M.A., Johnston, J.A. et al. Advances in Non-Nicotine Pharmacotherapy for Smoking Cessation. Drugs 59, 17–31 (2000). https://doi.org/10.2165/00003495-200059010-00003

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