期刊
PHARMACOTHERAPY
卷 38, 期 2, 页码 235-258出版社
WILEY
DOI: 10.1002/phar.2073
关键词
smoking cessation; tobacco cessation; nicotine dependence; pharmacotherapy
资金
- Janssen
- Lundbeck
- Otsuka
- National Institutes of Health
- Simons Autism Foundation
- Cancer Council of Victoria
- Stanley Medical Research Foundation
- Medical Benefits Fund
- National Health and Medical Research Council (NHMRC)
- Beyond Blue, Rotary Health, Geelong Medical Research Foundation
- Bristol-Myers Squibb
- Eli Lilly
- GlaxoSmithKline
- Meat and Livestock Board
- Organon
- Novartis
- Mayne Pharma
- Servier
- Woolworths
- Stanley Medical Research Institute
- NHMRC
- Beyond Blue
- Australian Rotary Health Research Fund
- Geelong Medical Research Foundation
- Fondation FondaMental
Tobacco use disorder is a chronic illness. With its high comorbidity rate, it is a major cause of years of life lost or years lived with disability; however, it is also considered the most preventable cause of death in developed countries. Since the development of nicotine replacement therapy (NRT) in 1978, treatment options have continued to evolve and expand. Despite this, currently available treatments remain insufficient, with less than 25% of smokers remaining abstinent 1 year after treatment. In this article, we review existing and emerging smoking cessation pharmacotherapies, with a special emphasis on the most promising agents that are currently being investigated. A search of the Cochrane Database of Systematic Reviews and the PubMed, Ovid, and ClinicalTrials.gov databases (August 2 to September 1, 2017) was undertaken for articles on smoking cessation pharmacotherapies, applying no language restrictions. More than 40 pharmacotherapies were reviewed including conventional pharmacotherapiesNRT, bupropion, and varenicline (all approved by the U.S. Food and Drug Administration as first-line treatment of smoking cessation)and novel therapies: cytisine, N-acetylcysteine, cycloserine, memantine, baclofen, topiramate, galantamine, and bromocriptine. Studies of combination NRT and varenicline showed the greatest smoking cessation rates. Clonidine and nortriptyline are second-line treatments used when first-line treatments fail or are contraindicated, or by patient preference. Some novel therapies, especially acetylcholinesterase inhibitors, cytisine, and N-acetylcysteine, display promising results. Because the results of randomized clinical trials were reported using varied end points and outcome measures, direct comparisons between different pharmacotherapies cannot easily be evaluated. Additional high-quality randomized double-blind placebo-controlled trials with long-term follow-up, using validated sustained abstinence measures, are needed to find more effective smoking cessation aids.
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