Developments in pharmacotherapy for tobacco dependence: past, present and future

UMMS Affiliation

Department of Psychiatry



Document Type


Medical Subject Headings

Adolescent; Adult; Bupropion; Clinical Trials as Topic; Clonidine; Drug Administration Routes; Female; Humans; Male; Nicotine; Nicotinic Agonists; Nortriptyline; Pregnancy; Smoking; Smoking Cessation; Treatment Outcome




In the mid-1970s there were no effective pharmacological treatments for tobacco dependence. The invention of nicotine gum was a major treatment advance and also greatly helped our understanding of the nature of tobacco dependence. There are now eight effective pharmacotherapies (nicotine gum, patch, nasal spray, inhaler, lozenge/tablet, bupropion, nortriptyline and clonidine) available to aid smoking cessation. Other non-nicotine agents that show promise are under investigation, including glucose, rimonabant, selegiline and varenicline. Greater knowledge of the mechanisms of action of the effective non-nicotine agents should lead to better understanding of the nature of tobacco dependence. Future research into optimal treatments should examine long-term combination pharmacotherapy combined with improved psychosocial support that is partly designed to enhance medication compliance. In addition, there is a need for studies designed to evaluate the efficacy of pharmacotherapies in populations such as youth, pregnant smokers and smokers with co-occurring mental health problems.

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Citation: Drug Alcohol Rev. 2006 Jan;25(1):59-71. Link to article on publisher's site

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