Pharmacotherapy for Treating Tobacco Dependence
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Various forms of nicotine replacement therapy and bupropion have been found to be efficacious and well tolerated for treating patients dependent on tobacco. However, the currently recommended duration of treatment with pharmacotherapy may be insufficient for some smokers to achieve sustained abstinence from tobacco. Extending the use of pharmacotherapy beyond the recommended timeframe may be an effective strategy for helping tobacco users achieve abstinence and for preventing relapse to tobacco use, especially among those who are highly dependent and those who are concerned about body weight gain following cessation.
Several studies have reported on long-term use of various pharmacotherapies. These studies have demonstrated that such long-term use is not harmful. Moreover, compared with continued smoking, long-term use of pharmacotherapy exposes patients to relatively small amounts of nicotine and none of the cancer-causing chemicals found in cigarettes and other tobacco products. However, more research is needed to further clarify questions regarding the ideal duration of therapy. Two questions have yet to be answered: In what populations of smokers is long-term therapy an effective strategy for achieving abstinence and preventing relapse? Does wider availability of nicotine replacement therapy lead to initiation of nicotine addiction by children and others not using tobacco products? Also, as with all medications, additional documentation of the safety of prolonged use of pharmacotherapy is important.
The aim of this review is to present the current evidence supporting the notion that long-term therapy for treating tobacco dependence may be appropriately considered for some tobacco users.
KeywordsNicotine Smoking Cessation Bupropion Withdrawal Symptom Nicotine Replacement Therapy
This research was supported in part by the National Cancer Institute P50-CA84724 centre grant and minority supplements.
- 4.Fagerstrom KO. Nicotine replacement: present and future. CVD Prev 1999 Jun; 2(2): 145–9Google Scholar
- 7.Physicians’ Desk Reference. 56th ed. Montvale (NJ): Medical Economics Company, Inc., 2002Google Scholar
- 8.Fiore MC, Bailey WC, Cohen SJ, et al. Treating tobacco use and dependence: clinical practice guideline. Rockville (MD): US Department of Health and Human Services Public Health Service, 2000 JunGoogle Scholar
- 10.Brigham J, Henningfield JE, Stitzer ML. Smoking relapse: a review. Int J Addict 1991; 25 (9A, 10A): 1239–55Google Scholar
- 16.Hughes JR. Dependence on and abuse of nicotine replacement medications: an update. In: Benowitz NL, editor. Nicotine safety and toxicity. New York: Oxford University Press, 1998: 147–57Google Scholar
- 23.Murray RP, Daniels K. Long-term nicotine therapy. In: Benowitz NL, editor. Nicotine safety and toxicity. New York: Oxford University Press, 1998: 173–82Google Scholar
- 34.Stratton K, Shetty P, Wallace R, et al. Clearing the smoke: assessing the science base for tobacco harm reduction: Institute of Medicine. Washington, DC: National Academy Press, 2001Google Scholar
- 35.Hurt RD. Clinical implications of long-term nicotine use. In: Ferrence R, Slade J, Room R, et al., editors. Nicotine and public health: the American Public Health Association. Washington, DC: United Book Press, 2000: 389–428Google Scholar
- 40.National Center for Tobacco-Free Kids: petition for Food and Drug Administration regulation of Activa tobacco lozenges [online]. Available from URL: http://tobaccofreekids.org/reports/newproducts/petition.pdf [Accessed 2002 Jul 16]