In 2008, the Centers for Disease Control and Prevention reported that 46 million adults in the United States were cigarette smokers. About half who keep smoking will die from smoking-related illnesses. The American Cancer Society reports that 70 percent of people who smoke want to quit, but many are unsuccessful because of physical addiction and emotional attachment to smoking. Medications and smoking cessation aids are available to help reduce withdrawal symptoms and increase the chances of quitting successfully.
Varenicline
Varenicline is a prescription medication that does not contain nicotine. Varenicline, approved for individuals 18 years and older, works by targeting nicotine receptors in the brain and attaching to them. Nicotine is blocked from reaching these receptors, which reduces cravings and the pleasurable effects of tobacco. Varenicline also blocks nicotine receptors, which causes a decrease in dopamine release. A study published in July 2006 in the "Journal of the American Medical Association" found that during weeks nine to 52, 23 percent of participants taking varenicline continued to be absent from smoking, compared with 10.3 percent in the placebo group and 14.6 percent in the bupropion SR group. The most common side effects of varenicline are nausea, vomiting, constipation and trouble sleeping. The U.S. Food and Drug Administration requires packaging to display a boxed warning that highlights the risk of serious psychiatric symptoms in some patients. Symptoms include changes in behavior, hostility, depressed mood, agitation, suicidal ideation and suicide. Psychiatric adverse effects can occur in individuals without a prior history of psychiatric symptoms.
Bupropion Hydrochloride
Bupropion hydrochloride is an antidepressant that is used as a smoking cessation aid. Bupropion works by blocking the reuptake of dopamine and norepinephrine, which is thought to diminish nicotine cravings and causes a decreased interest in smoking. Bupropion also reduces symptoms of nicotine withdrawal. Side effects include dry mouth, insomnia, dizziness, anxiety, upset stomach and constipation. There is a small risk of seizure when taking bupropion, so it should never be taken by individuals who have a history of seizure disorder, eating disorders or alcohol abuse.
Nicotine Replacement Therapy (NRT)
Nicotine replacement therapy provides a safe dose of nicotine to make dealing with nicotine withdrawal easier. Nicotine replacement will not make an individual quit smoking, but nicotine gum, nicotine patches, nicotine inhalers and nicotine lozenges help decrease urges to smoke, especially during the early days of quitting smoking when behavior changes are essential to success. Many individuals may become addicted to the nicotine replacement patches, but cigarette smoking is more harmful than nicotine delivered through replacement therapy. Smokers choose the type of NRT that works best for them and NRT should be combined with a smoking cessation program for optimal benefit. A doctor should always be consulted before combining NRT with another smoking cessation aid.
