Smoking Cessation

Nicotine Addiction: Behavioral and Pharmacotherapy Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Women: USPTS Task Force Recommendation Statement Annals 2015    Behavioral and Pharmacotherapy Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Women: USPTS Task Force Recommendation Statement Annals 2015 Pharmacotherapy Combinations of Nictoine Replacement Therapy Varenicline  Both of these are equally effective therapy  Other Head-to-head study of Bupropion and Nictotine replacement showed equal efficacy Nicotine replacement* gum : 1 piece (2 mg) whenever urge to smoke up to 30 pieces/day;continuous use for >3 months not recommended Nicotine 24-hour patch:  21-mg patch/y once daily for 4–8 weeks (remove and replace other forms of nicotine every 24 hours).  Then 14-mg replacement patch/day for 2–4 weeks followed by  7-mg replacement patch/day for 2–4 weeks Adults weighing less than 100 pounds, smoking fewer than and risk for recurrent coronary events or 10 cigarettes/day and/or with cardiovascular disease  14-mg patch/y once daily for 4–8 weeks (remove and replace other forms of nicotine every 24 hours).  Then 7-mg replacement patch/day for 2–4 weeks  Nicotine Spray:  Nicotine Inhaler: Nicotine Lozenges:  Bupropion: (Up-to-date) Initial: 150 mg once daily for 3 days; increase to 150 mg twice daily; treatment should continue for 7 to 12 weeks (maximum dose: 300 mg daily). Therapy should begin at least 1 week before target quit date. Target quit dates are generally in the second week of treatment. If patient successfully quits smoking after 7 to 12 weeks, may consider ongoing maintenance therapy based on individual patient risk:benefit. Efficacy of maintenance therapy (300 mg daily) has been demonstrated for up to 6 months. Conversely, if significant progress has not been made by the seventh week of therapy, success is unlikely and treatment discontinuation should be considered. Varenicline: (Up-to-date) Initial: Days 1 to 3: 0.5 mg once daily; Days 4 to 7: 0.5 mg twice daily Maintenance (≥ Day 8): 1 mg twice daily for 11 weeks Start 1 week before target quit date. Alternatively, patients may consider setting a quit date up to 35 days after initiation of varenicline  Supporting smoking cessation BMJ 2014 Smoking Cessation AAFP 2012 e-Cigarettes (for Patients) JAMA 2014 Electronic Cigarettes (The Medical Letter on Drugs and Therapeutics) JAMA 2014 Smoking cessation and reduction in people with chronic mental illness BMJ 2015 Smoking Cessation Pharmacological Treatments for Smoking Cessation Clinical Evidence Synopsis JAMA 2014 e-Cigarettes Match Nicotine Patches in Smoking Quit Rates JAMA 2013