Smoking Cessation Treatment Options

Types and suitabilities of smoking cessation treatments.

Smoking Cessation Treatment Options
BUPROPIONNICOTINEVARENICLINE
Brand Zyban

Nicorette
Nicotinell
Niquitin

Champix
Presentation Prolonged-release, film-coated tablets Gum
Inhalator (Nicorette only)
Lozenges
Microtabs (Nicorette only)
Nasal Spray (Nicorette only)
Orodispersible film (Niquitin only)
Oromucosal spray (Nicorette only)
Transdermal patches
Film-coated tablets
Treatment duration 7-9 weeks 10-12 weeks 12 weeks
Contraindications
  • History of seizures
  • CNS tumour
  • Bulimia, anorexia nervosa
  • Bipolar disorder
  • Severe hepatic cirrhosis
  • Patients experiencing abrupt withdrawal of alcohol or benzodiazepine
None None
Use in pregnancy No Yes
  • Intermittent dosing products are preferable as they provide lower daily dose of nicotine
  • Patches may be preferred if woman suffering from nausea
  • Patches should be removed before going to bed
  • Aim to discontinue after 2-3 months
No
Use in lactation No Yes
(intermittent dosing products are preferable)
No
Recommended by NICE? Yes Yes Yes
Mode of action Inhibits the reuptake of noradrenaline and dopamine resulting in a reduction in craving and withdrawal symptoms. Nicotine replacement therapy allows the psychological addiction of the smoking habit to be dealt with separately from the physical addiction to nicotine. Binds to nicotinic acetylcholine receptors to alleviate symptoms of craving and withdrawal.
Also competes with nicotine at the receptor binding sites, resulting in a reduction of the rewarding and reinforcing effects of smoking.
  • All smokers should be advised to stop and offered help if interested in doing so.
  • Smoking cessation therapies should be offered when appropriate, and where possible, smokers should have access to a smoking cessation clinic or programme for behavioural support.

 

KEYWORDS: NRT


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