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Pharmacologic Treatments for Smoking Cessation

Jiménez-Ruiz, Carlos A. MD, PhD*; Fagerström, Karl O. PhD; Miranda, Juan Antonio Riesco MD

doi: 10.1097/CPM.0b013e3181672252
Topics in Pulmonary Medicine

Smoking is recognized as a chronic and recurrent addictive disease. It is the leading preventable cause of death in the world and kills 4 million people worldwide annually. Because of the high morbidity and mortality associated with tobacco use and the substantial benefits of cessation, it is vital that all physicians encourage their patients who smoke to quit and assist in their smoking cessation attempts. According to the United States Public Health Service Clinical Practice Guideline on Treating Tobacco Use and Dependence: “smoking cessation treatment should include a combination of pharmacotherapy, to relieve the smoker's dependence on nicotine, as well as psychologic support to combat the smoker's addiction to inhaled tobacco consumption.” This review discusses the rationale behind the use of pharmacotherapy for smoking cessation and the recommended first- and second-line therapies. It also focuses on the new medication for smoking cessation: varenicline.

This article describes current pharmacological treatments for smoking cessation and explains their mechanisms of action, and efficacy and safety in clinical practice. The rationale for using these medications for smoking cessation is discussed.

From the *Smokers Clinic, Public Health Institute, Madrid, Spain; †Smokers Information Centre, Helsingborg, Sweden; and ‡Hospital Clinic, IDIBAPS, Barcelona, Spain.

Address correspondence to: Dr. C. Jiménez-Ruiz, C/Santa Cruz del Marcenado, 9 Madrid 28015, Spain. E-mail:,

© 2008 Lippincott Williams & Wilkins, Inc.