Feature Article

Recent developments in smoking cessation

Colin P Mendelsohn



New research into nicotine replacement therapy (NRT) has delivered creative ways to enhance the use and effectiveness of existing products, such as pre-quit treatment with nicotine patches, combination NRT and the use of nicotine products in unmotivated smokers. The new drug varenicline is another potent tool for helping smokers quit.

Key Points

  • Pharmacotherapy should be offered to all motivated smokers who are nicotine dependent.
  • Nicotine patches should be started two weeks before quitting in motivated smokers.
  • Nicotine gum or a nicotine inhaler should be used to help unmotivated smokers quit.
  • The most effective therapies are combination nicotine replacement therapy, varenicline and pre-quit nicotine patches.
  • Nicotine replacement therapy should be continued after a lapse to prevent progression to a full relapse.
  • The new drug varenicline is an effective and well-tolerated first-line smoking cessation therapy.