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Tobacco Cessation

  • Maher Karam-Hage
  • Paul M. Cinciripini
Chapter
Part of the MD Anderson Cancer Care Series book series (MDCCS)

Abstract

Tobacco use is behind most preventable diseases with disabling consequences and death. These diseases are among the most serious, including cancer, cardiovascular diseases (brain strokes, cardiac infarcts, peripheral artery disease), and respiratory system diseases (emphysema, chronic infections). It is estimated that one-third of cancers are attributable to tobacco use and in theory can be prevented. Therefore, a comprehensive tobacco cessation program is a crucial element of successful survivorship and cancer prevention programs. Smoking cigarettes is the most common and deadliest method of consuming tobacco, and nicotine is the reinforcing substance in any tobacco use that with long-term exposure leads to dependence (addiction). Nicotine dependence involves biological, behavioral, and cognitive elements; an optimal approach to treatment for nicotine dependence should address each of these three dimensions. A comprehensive tobacco/smoking cessation program should include cognitive behavioral techniques, motivational interviewing approaches, and appropriate medications. Currently the medications approved by the US Food and Drug Administration for the treatment of nicotine dependence include nicotine replacement therapies, bupropion-SR (sustained release), and varenicline; these treatments can be used individually or in combination. Combining medications capitalizes on the synergy resulting from differing mechanisms of action.

Keywords

Cancer Survivor Smoking Cessation Nicotine Dependence Nicotine Replacement Therapy Nicotine Patch 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Suggested Readings

  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC: American Psychiatric Association; 2013.Google Scholar
  2. Beckham JC. Smoking and anxiety in combat veterans with chronic posttraumatic stress disorder: a review. J Psychoactive Drugs 1999;31:103–110.PubMedCrossRefGoogle Scholar
  3. Benowitz NL. Neurobiology of nicotine addiction: implications for smoking cessation treatment. Am J Med 2008;121:S3–S10.PubMedCrossRefGoogle Scholar
  4. Cahill K, Stead LF, Lancaster T. Nicotine receptor partial agonists for smoking cessation. Cochrane Database of Systematic Review 2011;2:1–87.Google Scholar
  5. Ebbert JO, Croghan IT, Sood A, Schroeder DR, Hays JT, Hurt RD. Varenicline and bupropion sustained release combination therapy for smoking cessation. Nicotine Tob Res 2009;11:234–239.PubMedCrossRefGoogle Scholar
  6. Ebbert JO, Hays JT, Hurt RD. Combination pharmacotherapy for stopping smoking: what advantages does it offer? Drugs 2010;70:643–650.PubMedCrossRefPubMedCentralGoogle Scholar
  7. Fiore MC, Jaen CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: US Department of Health and Human Services; 2008.Google Scholar
  8. Gonzales D, Rennard SI, Nides M, et al. Varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs sustained-release bupropion and placebo for smoking cessation: a randomized controlled trial. JAMA 2006;296:47–55.PubMedCrossRefGoogle Scholar
  9. Hertzberg MA, Moore SD, Feldman ME, Beckham JC. A preliminary study of bupropion sustained-release for smoking cessation in patients with chronic posttraumatic stress disorder. J Clin Psychopharmacol 2001;21:94–98.PubMedCrossRefGoogle Scholar
  10. Hughes JR, Stead LF, Hartman-Boyce J, Cahill K, Lancaster T. Antidepressants for smoking cessation. Cochrane Database of Systematic Reviews 2014;1:CD000031 pub4.Google Scholar
  11. Hughes JR, Stead LF, Lancaster T. Antidepressants for smoking cessation. Cochrane Database of Systematic Reviews 2007;1:CD000031.PubMedGoogle Scholar
  12. Jorenby DE, Hays JT, Rigotti NA, et al. Efficacy of varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs placebo or sustained-release bupropion for smoking cessation: a randomized controlled trial. JAMA 2006;296:56–63.PubMedCrossRefGoogle Scholar
  13. Karam-Hage M, Cinciripini PM. Pharmacotherapy for tobacco cessation: nicotine agonists, antagonists, and partial agonists. Curr Oncol Rep 2007;9:509–516.PubMedCrossRefGoogle Scholar
  14. Karam-Hage M, Shah K, Cinciripini PM. Addition of bupropion-SR to varenicline alleviated depression and suicidal ideation: a case report. Prim Care Companion J Clin Psychiatry 2010;12:e1.Google Scholar
  15. Lasser K, Boyd JW, Woolhandler S, Himmelstein DU, McCormick D, Bor DH. Smoking and mental illness: a population-based prevalence study. JAMA 2000;284:2606–2610.PubMedCrossRefGoogle Scholar
  16. Physicians’ Desk Reference. 67th ed. Montvale, NJ: Thompson Publications; 2013.Google Scholar
  17. Piper ME, Smith SS, Schlam TR, et al. A randomized placebo-controlled clinical trial of 5 smoking cessation pharmacotherapies. Gen Psychiatry 2009;66:1253–1262.CrossRefGoogle Scholar
  18. Silagy C, Lancaster T, Stead L, Mant D, Fowler G. Nicotine replacement therapy for smoking cessation. Cochrane Database of Systematic Reviews 2004;3:CD000146.PubMedGoogle Scholar
  19. Smith SS, McCarthy DE, Janovitch S, et al. Comparative effectiveness of 5 smoking cessation pharmacotherapies in primary care clinics. MD Arch Intern Med 2009;169:2148–2155.CrossRefGoogle Scholar
  20. Tonstad S, Tonnesen P, Hajek P, et al. Effect of maintenance therapy with varenicline on smoking cessation: a randomized controlled trial. JAMA 2006;296:64–71.PubMedCrossRefGoogle Scholar
  21. US Centers for Disease Control and Prevention (CDC). Vital signs: current cigarette smoking among adults aged ≥18 years—United States, 2009. MMWR Morb Mortal Wkly Rep 2010;59:1135–1140.Google Scholar
  22. US Centers for Disease Control and Prevention (CDC). State-specific trends in lung cancer incidence and smoking—United States, 1999–2008. MMWR Morb Mortal Wkly Rep 2011;60:1243–1247.Google Scholar
  23. US Centers for Disease Control and Prevention (CDC). Surveillance of demographic characteristics and health behaviors among adult cancer survivors—behavioral risk factor surveillance system, United States, 2009. MMWR Morb Mortal Wkly Rep 2012;61:1–23.Google Scholar
  24. US Department of Health and Human Services. Reducing Tobacco Use: A Report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, Public Health Service, Centers for Disease Control, Centers for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2000.Google Scholar
  25. US Food and Drug Administration (FDA). Public Health Advisory: Important Information on Chantix (varenicline). Rockville, MD: US Department of Health and Human Services; 2008.Google Scholar
  26. Volkow ND, Fowler J, Wang G-J. Role of dopamine in drug reinforcement and addiction in humans: results from imaging studies. Behav Pharmacol 2002;13:355–366.PubMedCrossRefGoogle Scholar

Copyright information

© The University of Texas M. D. Anderson Cancer Center 2015

Authors and Affiliations

  • Maher Karam-Hage
    • 1
  • Paul M. Cinciripini
    • 1
  1. 1.Department of Behavioral ScienceThe University of Texas MD Anderson Cancer CenterHoustonUSA

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