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Novel Pharmacological Approaches for Treating Tobacco Dependence and Withdrawal

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Abstract

Increasing the diversity and availability of medications for the treatment of tobacco dependence and/or withdrawal, to aid in the achievement of smoking cessation, is crucial to meet the diverse needs of tobacco users. Despite a general awareness that smoking is harmful and widespread interest in smoking cessation, nearly 50 million adults in the US and 1.3 billion worldwide continue to smoke. Nicotine replacement therapies are effective in the treatment of tobacco dependence and withdrawal, but do not meet the needs of all tobacco users. Improvement of tobacco dependence and/or withdrawal treatments is likely to rely on novel pharmacological approaches that include new chemical entities and new formulations of current drugs. In addition, new indications for treating tobacco dependence and withdrawal show promise for reducing tobacco use and associated disease.

This article focuses on a range of novel pharmacological approaches for the treatment of tobacco dependence and/or withdrawal, including oral and pulmonary nicotine delivery and the following non-nicotinic medications: antidepressants, an α4β2 nicotine partial agonist, an α2-noradrenergic agonist, cytochrome P450 (CYP) 2A6 inhibitors, opioid antagonists and GABAergic medications. In addition to existing medications, this article addresses novel medications in the clinical development stage and those that have been evaluated previously. Novel medications in the clinical development stage include at least three nicotine vaccines and the cannabinoid receptor acting drug rimonabant. Medications evaluated previously include lobeline, mecamylamine and an anticholinergic drug regimen comprising atropine, scopolamine and chlorpromazine. Having not been approved by major drug regulatory authorities for the treatment of tobacco dependence and/or withdrawal, these medications have been evaluated in an experimental capacity.

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Notes

  1. The use of trade names is for product identification purposes only and does not imply endorsement.

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Acknowledgements

Administrative and salary support was provided by Pinney Associates (www.pinneyassociates.com), which has an exclusive consulting relationship with GlaxoSmithKline Consumer Healthcare (a marketer of tobacco dependence treatments) on issues related to treating tobacco dependence. Additional support was provided to Dr Henningfield by the Robert Wood Johnson Foundation Innovators Awards Program at The Johns Hopkins University School of Medicine (www.InnovatorsAwards.org). Dr Henningfield also has a financial interest in a smoking cessation medication under development.

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  1. Pinney Associates, Bethesda, Maryland, USA

    August R. Buchhalter & Reginald V. Fant

  2. Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

    Jack E. Henningfield

  3. Research and Health Policy, Pinney Associates, 3 Bethesda Metro Center, Suite 1400, Bethesda, Maryland, 20814, USA

    Jack E. Henningfield

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  1. August R. Buchhalter
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  2. Reginald V. Fant
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Correspondence to Jack E. Henningfield.

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Buchhalter, A.R., Fant, R.V. & Henningfield, J.E. Novel Pharmacological Approaches for Treating Tobacco Dependence and Withdrawal. Drugs 68, 1067–1088 (2008). https://doi.org/10.2165/00003495-200868080-00005

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