Nicotine addiction management

 


Management on Nicotine Addiction -

Nicotine replacement therapy
Nicotine replacement therapy (NRT) works by making it easier to abstain from tobacco by partially replacing the nicotine previously obtained from tobacco. All of the commercially available forms of NRT increase the chances of successful smoking cessation. Overall, NRT increases the quit rate by 50-70%, and the increase appears to be independent of any additional support provided.

Types of NRT products on the market today include the following:
Transdermal nicotine patch
Nicotine nasal spray
Nicotine gum
Nicotine lozenge
Sublingual nicotine tablet
Nicotine inhaler

Non-nicotine pharmacotherapy
The medications bupropion and varenicline have demonstrated efficacy for smoking cessation.
Bupropion acts by alleviating some of the symptoms of nicotine withdrawal. Like NRT products, bupropion has been endorsed by the US Clinical Practice Guideline as a first-line therapy. Compared with placebo, bupropion approximately doubles smoking cessation rates, and it is equally effective for men and women.
Varenicline is a partial agonist that is selective for alpha-4, beta-2 nicotinic acetylcholine receptors (nAChRs). The drug helps smokers quit by preventing withdrawal symptoms while moderate levels of dopamine are maintained in the brain.
Some reviews have found that patients receiving varenicline are at an increased risk for serious adverse cardiovascular events. On the basis of study findings, extreme caution should be used when considering varenicline for patients with known cardiovascular problems.
Combination treatment with varenicline and bupropion may be more effective than single-drug therapy for smoking cessation in those smokers motivated to quit.

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