The biggest problem is that many people cease smoking for a few days, but the urge to smoke is so overwhelming that they start smoking again, thus the relapse rates are higher. Smoking Cessation and Nicotine Dependence cause headaches, nausea, anxiety, depression, insomnia, increased appetite and associated weight gain, thereby leading to relapse in many cases.
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Smoking Cessation is the process of quitting cigarette and tobacco smoking. Cigarette smoking is the most important risk factor leading to the development of Chronic obstructive pulmonary disease (COPD) and therefore, the most important therapeutic intervention both to reduce symptoms in patients who manifest COPD and, more importantly, to prevent the development of COPD. The most important active compound in cigarette smoke contributing to addiction is nicotine. This nicotine addiction pose great difficulty for the smokers from stopping smoking permanently.
Currently, the market holds numerous treatment options for quitting smoking. There are effective treatments that support tobacco cessation, including both behavioral therapies and FDA-approved medications. The US Food and Drug Administration (FDA) has approved a variety of smoking-cessation aids, including prescription drugs and over-the-counter (OTC) products, such as skin patches, lozenges, and gum.
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Initial medications used to aid the patients in smoking cessation is nicotine replacement therapy (NRT) and sustained release (SR) Bupropion. Other medications used as second-line treatment are clonidine, nortriptyline, and varenicline. Varenicline provides some nicotine-like effects to lessen the symptoms of withdrawal, and it prevents the effects of nicotine if cigarette user’s start smoking again. Clonididine and Nortriptyline are not approved by the FDA but is off-label preferred as it gives significant results.
A variety of formulations of nicotine NRTs are available over the counter—including the transdermal patch, spray, gum, and lozenges—and are equally useful for cessation. A combination of continual nicotine delivery through the transdermal patch and one other form of nicotine taken as needed (e.g., lozenge, gum, nasal spray, inhaler) is more effective at relieving withdrawal symptoms and cravings than a single type of NRT. A prescription-only nicotine replacement medication is Nicotrol, which is available as a nasal spray and as an oral inhaler.
