Pharmacological approach to smoking cessation and effective intervention models
Keywords:Smoking, Cessation, Quit, Pharmacological
One of the main public health issues is tobacco use, which is also associated with considerate morbidity and mortality worldwide. Smoking cessation lowers mortality and risk of future cardiovascular events. Smoking is a true chronic condition that is defined by the emergence of a dependency state that is primarily caused by nicotine. Smokers are typically unable to quit smoking on their own. There are numerous approaches to treating smoking addiction, including both non-pharmacological such as behavioural counselling and pharmacological therapy. The effectiveness and safety of smoking cessation medications in everyday life are currently widely acknowledged. The primary pharmacological methods for quitting smoking include nicotine replacement therapy, varenicline, bupropion, and cytisine. Even in patients with chronic cardiovascular disease, their effectiveness and safety have been demonstrated. It has been demonstrated that nicotine replacement therapy, bupropion, varenicline, and cytisine increase the likelihood of cessation. Both varenicline and nicotine replacement therapy in combination are powerful tools for cessation. The likelihood of quitting is likewise increased by nortriptyline. Research suggests that none of the treatments seem to have a frequency of adverse reactions that would limit their usage. The clinician should tailor the smoking cessation strategy based on the most recent scientific data and the patient's preferences, giving particular attention to those patients who have certain cardiovascular and psychiatric comorbidities. The purpose of this research is to review the available information about pharmacological approach to smoking cessation and effective intervention models.
Alberg AJ. Cigarette smoking: health effects and control strategies. Drugs of today (Barcelona, Spain : 1998). 2008;44(12):895-904.
Mackenbach JP, Damhuis RA, Been JV. [The effects of smoking on health: growth of knowledge reveals even grimmer picture]. Nederlands tijdschrift voor geneeskunde. 2017;160:D869.
Jafari A, Rajabi A, Gholian-Aval M, Peyman N, Mahdizadeh M, Tehrani H. National, regional, and global prevalence of cigarette smoking among women/females in the general population: a systematic review and meta-analysis. Env Health Prev Med. 2021;26(1):5.
Giulietti F, Filipponi A, Rosettani G, Giordano P, Iacoacci C, Spannella F, et al. Pharmacological Approach to Smoking Cessation: An Updated Review for Daily Clinical Practice. High Blood Press Cardiovasc Prev. 2020;27(5):349-62.
Aubin HJ, Luquiens A, Berlin I. Pharmacotherapy for smoking cessation: pharmacological principles and clinical practice. Br J Clin Pharmacol. 2014;77(2):324-36.
Onor IO, Stirling DL, Williams SR, Bediako D, Borghol A, Harris MB, et al. Clinical Effects of Cigarette Smoking: Epidemiologic Impact and Review of Pharmacotherapy Options. Int J Environ Res Public Health. 2017;14(10).
Cahill K, Stevens S, Perera R, Lancaster T. Pharmacological interventions for smoking cessation: an overview and network meta-analysis. Cochrane Database Systemat Rev. 2013;2013(5):Cd009329.
Lindson N, Klemperer E, Hong B, Ordóñez-Mena JM, Aveyard P. Smoking reduction interventions for smoking cessation. Cochrane Database Systemat Rev. 2019;9(9):Cd013183.
Wadgave U, Nagesh L. Nicotine Replacement Therapy: An Overview. Int J Health Sci. 2016;10(3):425-35.
Moore D, Aveyard P, Connock M, Wang D, Fry-Smith A, Barton P. Effectiveness and safety of nicotine replacement therapy assisted reduction to stop smoking: systematic review and meta-analysis. BMJ (Clinical research ed). 2009;338:b1024.
Stead LF, Perera R, Bullen C, Mant D, Hartmann-Boyce J, Cahill K, et al. Nicotine replacement therapy for smoking cessation. Cochrane Database Systemat Rev. 2012;11:Cd000146.
Hartmann-Boyce J, Chepkin SC, Ye W, Bullen C, Lancaster T. Nicotine replacement therapy versus control for smoking cessation. Cochrane Database Systemat Rev. 2018;5(5):Cd000146.
Hajek P, Phillips-Waller A, Przulj D, Pesola F, Smith KM, Bisal N, et al. E-cigarettes compared with nicotine replacement therapy within the UK Stop Smoking Services: the TEC RCT. Health Technol Assessment (Winchester, England). 2019;23(43):1-82.
Leischow SJ, Muramoto ML, Matthews E, Floden LL, Grana RA. Adolescent Smoking Cessation With Bupropion: The Role of Adherence. Nicotine Tobacco Res. 2016;18(5):1202-5.
Schnoll RA, Martinez E, Tatum KL, Weber DM, Kuzla N, Glass M, et al. A bupropion smoking cessation clinical trial for cancer patients. Cancer Causes Control. 2010;21(6):811-20.
Howes S, Hartmann-Boyce J, Livingstone-Banks J, Hong B, Lindson N. Antidepressants for smoking cessation. Cochrane Database Systemat Rev. 2020;4(4):Cd000031.
Hall SM, Reus VI, Muñoz RF, et al. Nortriptyline and cognitive-behavioral therapy in the treatment of cigarette smoking. Arch General Psychiatry. 1998;55(8):683-90.
Dickerson LM, Carek PJ. Nortriptyline effective for smoking cessation. J Fam Pract. 2002;51(12):1008.
Prochazka AV, Kick S, Steinbrunn C, Miyoshi T, Fryer GE. A randomized trial of nortriptyline combined with transdermal nicotine for smoking cessation. Arch Int Med. 2004;164(20):2229-33.
Prochazka AV, Weaver MJ, Keller RT, Fryer GE, Licari PA, Lofaso D. A randomized trial of nortriptyline for smoking cessation. Arch Int Med. 1998;158(18):2035-9.
Rigotti NA, Pipe AL, Benowitz NL, Arteaga C, Garza D, Tonstad S. Efficacy and safety of varenicline for smoking cessation in patients with cardiovascular disease: a randomized trial. Circulation. 2010;121(2):221-9.
Ebbert JO, Hughes JR, West RJ, et al. Effect of varenicline on smoking cessation through smoking reduction: a randomized clinical trial. JAMA. 2015;313(7):687-94.
Reus VI, Obach RS, Coe JW, Faessel H, Rollema H, Watsky E, et al. Varenicline: new treatment with efficacy in smoking cessation. Drugs of today (Barcelona, Spain : 1998). 2007;43(2):65-75.
Tutka P, Vinnikov D, Courtney RJ, Benowitz NL. Cytisine for nicotine addiction treatment: a review of pharmacology, therapeutics and an update of clinical trial evidence for smoking cessation. Addiction (Abingdon, England). 2019;114(11):1951-69.
Walker N, Howe C, Glover M. Cytisine versus nicotine for smoking cessation. N Engl J Med. 2014;371(25):2353-62.
Hajek P, McRobbie H, Myers K. Efficacy of cytisine in helping smokers quit: systematic review and meta-analysis. Thorax. 2013;68(11):1037-42.