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American Journal of Lifestyle Medicine
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Reviews

State of the Art Reviews: Smoking Cessation

A Review of Treatment Considerations

Karyn M . Sullivan, BSc Pharm , MPH

Massachusetts College of Pharmacy and Health Sciences, Worcester, Massachusetts, Karyn.sullivan{at}mcphs.edu

Sheila M. Seed, BSc Pharm , MPH

Massachusetts College of Pharmacy and Health Sciences, Worcester, Massachusetts

Ronald J. DeBellis, PharmD, FCCP

Massachusetts College of Pharmacy and Health Sciences, Worcester, Massachusetts

Smoking cessation continues to be an area of great concern for public health. Smoking status and willingness to quit should be assessed at every patient visit. A variety of nonprescription and prescription pharmacotherapy options exist for those willing to quit. Medications currently approved by the Food and Drug Administration for smoking cessation include nicotine replacement therapy (gum, lozenge, patch, inhaler, and nasal spray), bupropion sustained release, and the newly approved varenicline. Nortriptyline and clonidine are not indicated for smoking cessation but have been used as second-line agents. This review focuses on each treatment option, including precautions, proper dosing and duration, adverse effects, and medication delivery issues. Attention is also given to individual patient considerations such as combination therapy, pregnancy, postcessation weight gain, and effects of cessation on the current medication regimen.

Key Words: smoking cessation • nicotine replacement therapy • bupropion SR • nortriptyline • clonidine • varenicline

American Journal of Lifestyle Medicine, Vol. 1, No. 3, 201-213 (2007)
DOI: 10.1177/1559827606298725
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