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KMID : 1039620210110060403
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Korean Journal of Family Practice
2021 Volume.11 No. 6 p.403 ~ p.414
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Recent Updates of Pharmacotherapy for Smoking Cessation
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Hwang Ju-Sam
Lee Cheol-Min
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Abstract
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The use of tobacco, cigarette smoking in particular, is a leading causal factor of countless deaths and disabilities worldwide. Its widespread prevalence is a major global concern and is evidenced in various data research which suggests that an estimated 50.6 million US adults (Centers for Disease Control and Prevention) and 11.1 million Korean adults (Korean National Health and Nutrition Examination Survey) were using tobacco in 2019. Tobacco cessation is encouraged both nationally and globally for its clear and rapid health benefits. Today, multiple support medications exist to aid the quitting process, nicotine replacement therapy, varenicline, and bupropion. There are, however, limitations to available pharmacotherapy. Though the current tobacco treatment guidelines have established its efficacy and safety, pharmacotherapy does not provide smoking individuals with detailed answers for common questions or case specific questions. As such, now there are strong and updated recommendations to enhance the practice of pharmacotherapy. These includes using varenicline in place of bupropion and nicotine patches. Conditional recommendations advise combining a nicotine patch with varenicline rather than using varenicline alone and using varenicline instead of electronic cigarettes. In groups where standard use of varenicline is not applicable, efficacy and safety of alternative treatment paradigms of varenicline including extending use, increasing the dose, reduce-to-quit and flexible quit date approach, have been demonstrated. Most evidence presented in this article are cited from Cochrane reviews, 2018 American College of Cardiology Expert Consensus Decision Pathway, 2020 American Thoracic Society Documents, and 2021 US Preventive Services Task Force recommendation on tobacco cessation treatment.
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KEYWORD
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Smoking Cessation, Varenicline, Nicotine Replacement Products, Bupropion
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