What Are the Different Types of Stop-Smoking Medications?

Medication is a very effective method of quitting smoking, which increases the success rate of quitting smoking by reducing withdrawal symptoms. In May 2008, based on more than 8,000 references, the US Public Health Agency issued a new version of clinical practice guidelines on tobacco use and dependence treatment. ^[1] This guideline recommends 7 first-line clinical smoking cessation drugs that can effectively increase the long-term quitting effect, including 5 nicotine replacement therapy (NRT) smoking cessation drugs (nicotine chewing gum, nicotine inhaler, nicotine buccal tablets , Nicotine nasal spray and nicotine patch) and two non-nicotine smoking cessation drugs (valericlan tartrate and bupropion hydrochloride).

Medication is a very effective method of quitting smoking, which increases the success rate of quitting smoking by reducing withdrawal symptoms. In May 2008, based on more than 8,000 references, the US Public Health Agency issued a new version of clinical practice guidelines on tobacco use and dependence treatment. ^[1] This guideline recommends 7 first-line clinical smoking cessation drugs that can effectively increase the long-term quitting effect, including 5 nicotine replacement therapy (NRT) smoking cessation drugs (nicotine chewing gum, nicotine inhaler, nicotine buccal tablets , Nicotine nasal spray and nicotine patch) and 2 non-nicotine smoking cessation drugs (valeric acid tartrate tablets and bupropion hydrochloride).

Drug Name

Smoking cessation drugs

Main indications

Smokers

Smoking cessation drugs

In 2008, the new clinical practice guidelines for tobacco use and dependence treatment issued by the US Public Health Agency recommended first-line clinical smoking cessation drugs:

1. Nicotine replacement therapy (NRT) smoking cessation drugs: nicotine chewing gum, nicotine inhalers, nicotine buccal tablets, nicotine nasal sprays and nicotine patches.

2. Non-Nicotine Smoking Cessation Drugs: Valniklan Tartrate and Bupropion Hydrochloride

Nicotine replacement therapy

Nicotine replacement therapy (NRT) drugs reduce the symptoms of nicotine withdrawal, such as inattention, anxiety, irritability, and depression, by providing nicotine to the body in place of or in place of nicotine obtained from tobacco. NRT drugs are safe and effective in assisting smoking cessation, which can double the possibility of long-term smoking cessation. Although it does not completely eliminate the symptoms of withdrawal, it can reduce the discomfort of smoking cessation to varying degrees. The expected difficulty of quitting depends on the dependence of the smoker on nicotine rather than the amount of smoking, and whether to arrange the patients to use NRT drugs depends on the degree of nicotine dependence. Different NRT drugs provide nicotine in different ways. At present, there is no evidence that these drugs have different efficacy in quitting smoking. The choice of drugs should follow the wishes of quitters. Smokers often fail to achieve optimal treatment results due to failure to use adequate amounts of NRT drugs.

The course of NRT drugs should last 8 to 12 weeks, and a few smokers may need longer treatment (5% may need to continue treatment for up to 1 year). There are no safety issues with long-term NRT treatment. It should be used with caution in patients with myocardial infarction recently (within 2 weeks), severe arrhythmia, and unstable angina pectoris. Smokers during pregnancy should be encouraged to quit smoking through non-drug means. Whether different NRT drugs can help pregnant smokers quit smoking is inconclusive, and whether breastfeeding smokers are effective has not been evaluated.

Varianiclan

Vavaniklan (Vavaniklan tartrate) is a new type of non-nicotine smoking cessation drug, which has been approved by the US FDA for marketing in 2006 for smoking cessation in adults. The level of evidence recommended for smokers is A. Varianiclan has a high affinity and selectivity for 42 nicotine acetylcholine receptors in neurons. It is a partial agonist of nicotine acetylcholine receptors, and has both dual effects of agonism and antagonism. The combination of vavaniclan and nicotine acetylcholine receptors acts as an agonist, stimulating the release of dopamine, helping to relieve smokers' craving for tobacco and various withdrawal symptoms after quitting; at the same time, its antagonistic properties can prevent nicotine and receptor The combination reduces the pleasure of smoking and reduces the urge to smoke, thereby reducing the possibility of relapse. In a clinical study published in 2009 involving 15 centers in China, Singapore, and Thailand, varnaclan had a significantly better smoking cessation effect than placebo. The main efficacy endpoint was 9-12 weeks (including 12 weeks) after CO The rate of sustained smoking cessation confirmed by the measurement at 4 weeks was significantly higher in the valnickelan-treated group (50.3%) than in the placebo group (31.6%) ( P = 0.0003). There were statistically significant differences in key and other secondary efficacy indicators between the valnickelan group and the placebo group. ^[2]

Bupropion hydrochloride

Bupropion hydrochloride (sustained-release tablets) is the first non-nicotine smoking cessation drug that can effectively help smokers quit smoking. It was used to quit smoking in 1997. The level of evidence recommended for smokers is A. Bupropion hydrochloride is a dopaminergic and noradrenergic antidepressant. The mechanism of action may include inhibiting the reuptake of dopamine and norepinephrine and blocking the nicotine acetylcholine receptor. Bupropion hydrochloride is an oral medicine with a dose of 150 mg / tablet. It should be taken at least 1 week before quitting smoking, and the course of treatment is 7-12 weeks. Side effects include dry mouth, irritability, insomnia, headache and dizziness. Patients with epilepsy, anorexia or abnormal appetite, those who are taking drugs containing bupropion or those who have taken monoamine oxidase inhibitors in the past 14 days are contraindicated. For smokers who are heavily dependent on nicotine, the combined use of NRT drugs can increase the effect of smoking cessation.

Notes on smoking cessation drugs

In the course of smoking cessation treatment, NRT drugs, vaniklan (valvaline tartrate) and bupropion hydrochloride are frequently used drugs. In terms of the health benefits of smoking cessation, these drugs are effective treatments that can save lives. In combination with behavioral interventions, the success rate of smoking cessation will be improved, but smoking cessation drugs alone are still effective. Smoking is often mistaken as a purely personal choice, but this is not the case. After fully realizing the health hazards of smoking, most smokers are willing to quit smoking, but it is often difficult to quit because of the addictive nature of nicotine. Where possible, smoking cessation medications and smoking cessation counselling and counselling measures should be used simultaneously.