Smoking cessation: an overview of treatment options with a focus on varenicline

Tobacco use claims more than 440,000 lives each year, making it one of the leading causes of mortality in the United States. Although nearly half of all people who smoke die prematurely from tobacco-related illnesses, those who quit may be able to reverse many of the adverse effects of tobacco. Approximately 47.5 million adults use tobacco; nearly 70% of them want to quit, and 42.5% attempt to quit each year. The most effective smoking-cessation programs involve a combination of pharmacotherapy and behavioral and/or cognitive counseling to improve abstinence rates. Approved treatments include nicotine replacement therapies and bupropion, a nonnicotine option. Varenicline, the most recent agent approved for tobacco cessation, is the first drug in a new class that binds to the nicotinic receptors to release dopamine and alleviate withdrawal symptoms. It has demonstrated superior efficacy in clinical trials when compared with placebo and bupropion, with minimal adverse effects. It provides smokers and clinicians with an alternative therapy to assist in quitting tobacco.