Pharmacotherapy for Smoking Cessation

Tobacco smoking is a major public health hazard, one responsible for more deaths than alcohol, drugs, car accidents, HIV, and fire combined. While on the decline, it continues to be a major problem that is feasible but difficult to remedy, in particular once an individual is addicted to nicotine. On the bright side, effective treatments are available although very few people are taking advantage of these tools. The standard of care and evidenced-based treatment consist of behavioral in conjunction with pharmacological therapy. In the United States, there are seven pharmacological agents approved for use as single agents, while for heavily addicted or recalcitrant smokers a combination of more than one agent may be needed. Nicotine replacement products offer a safe way to transition from the harm of smoking tobacco to using only medicinal doses of nicotine for a gradual transition to total abstinence. E-cigarettes can be seen as a less harmful alternative to smoking; however, little is known about their potential for harm on long-term use.