There are more than 435,000 tobacco-related deaths every year in the Unite States. Smoking causes cancer, heart disease, stroke, chronic obstructive pulmonary disease -- or COPD -- and pregnancy complications. The health-care expenses to treat tobacco-related illnesses are estimated to be $96 billion per year. According to the surgeon General, about 21 percent of American adults smoke. This constitutes of about 45 million tobacco users.
Considerations
Tobacco is addictive which can make quitting very difficult. Approximately 44 percent of smokers try to quit smoking every year. Most of these efforts are unaided with cessation drugs, and only 4 to 7 percent will be successful. There are several types of U.S. Food and Drug Administration-approved cessation drugs that are considered be effective and safe. These include varenicline, clonidine, bupropion, nortriptyline, and nicotine gum, spray and patch.
Nicotine-Replacement Therapies
NRT medications are based on delivering nicotine to reduce withdrawal symptoms from tobacco. The drugs are considered effective with success rates from 19 to 27 percent, depending on the type of drug delivery. The nicotine nasal spray is the most effective with a success rate of 27 percent, followed by 26 percent with a long-term use of gum, 25 percent with an inhaler, 23 percent with a patch and 19 percent with a short-term use of gum. Long-term treatment is considered to be over 14 weeks. Nicotine spray and inhaler require prescription, whereas the gum and patch are over-the-counter drugs.
Drugs with High Success Rate
According to the surgeon general, varenicline has the highest success rate of 33 percent, when taken 1 mg, twice a day. Bupropion sustained release -- or SR -- has a success rate of 24 percent when used alone and almost 30 percent when used together with a nicotine patch. The success rates of clonidine and nortriptyline, are 25 and 23 percent. When nortriptylin is used in combination with the nicotine patch, the success rate is over 27 percent.
Drugs with Low Success Rate
Anti-depressants evaluated by the surgeon general, besides those of bupropion and nortriptyline, did not increase abstinence form tobacco. Selective serotonin re-uptake inhibitors -- or SSRIs -- that are a large group of anti-depressants, only show a low, 14 percent success rate. Another drug, with low effectiveness, is opioid antagonist naltrexone that only has a success rate of around 7 percent. Drugs, including mecamylamine, silver acetate, benzodiazepines, beta-blockers and diazepam, are also not considered effective.
