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KMID : 1231220150060010010
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Journal of the Korean Society for Research on Nicotine and Tobacco
2015 Volume.6 No. 1 p.10 ~ p.17
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Pharmacotherapy to Quit: Beyond the Guidelines
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Lee Cheol-Min
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Abstract
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Cigarette smoking is the single most important cause of preventable morbidity and mortality in the developed world. Although many smokers know the harm of cigarette smoking, only a few succeed in smoking cessation. Tobacco dependence is now considered as a chronic disease that often requires repeated intervention and multiple attempts to quit. There are effective treatment tools across a broad range of population. Medication is effective in smoking cessation treatment and current smoking cessation guidelines recommend nicotine re-placement therapy (NRT), bupropion, and varenicline as first line therapy. Not only va-renicline and NRT combination showed promising results in tobacco dependence treatment and also combination of varenicline and bupropion combination did. New combination was very helpful for successful smoking cessation for only heavy smokers and highly dependent smokers and it had more side effects. So, further research is necessary to evaluate the efficacy and side effect for the combination treatment. One study showed that a flexible quit date approach had similar efficacy compared with fixed quit date using varenicline. Pre-quit NRT may be associated with higher attempts to quit and success. Cytisine is an inexpensive drug that has been used for decades and there are some evidences showing its safety and effectiveness. Nicotine vaccine and electronic cigarette has yet limited evidence on smoking cessation.
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KEYWORD
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Smoking cessation, Varenicline, Nicotine Replacement therapy, Bupropion, cytisine, Electronic cigarette
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