ABSTRACT
This chapter focuses on the proper use of nicotine replacement therapy (NRT), varenicline, and bupropionSR, golden rules in smoking cessation, predictors of success, and the concept of smoking reduction. It should be remembered that cigarette smoking is an addiction, and for that reason smoking cessation cannot be compared with treatment of other medical conditions. NRT will produce low success rates when used without adjunctive behavioral support; however, since most smokers quit on their own and using over-the-counter (OTC) NRT, even these low success rates will have an important influence on public health. The degree of supportive adjunctive behavioral therapy parallels the actual success rate, while the relative success rate (i.e. the odds ratio between NRT and placebo) remains more or less unchanged at around a factor of two. 1
As a preventive tool, smoking cessation is very costeffective. Smoking cessation with NRT or bupropionSR is approximately eight times more cost-effective per saved year compared with 300 medical treatments. 2 Also, smoking is the most important etiologic factor in the development of lung cancer, accounting for almost 85% of all lung cancer cases, and has been strongly correlated with other cancers, including oral, laryngeal, and bladder cancer. Around one-third of all cancer deaths are attributed to tobacco. 3 Also, tobacco use is a major contributor to chronic obstructive pulmonary disease (COPD) and coronary arteriosclerosis – diseases that often prevent lung cancer patients from undergoing curative surgery.
