Pharmacologic intervention in habitual smoking.

The health risks associated with smoking justify efforts at cessation. Of the 50 million smokers in the United States, about 20 million attempt to quit each year. Approximately 6% are successful. Nicotine, the addictive agent within tobacco smoke, acts to enhance the release of neurotransmitters in the pleasure reinforcing area of the brain. Nicotine replacement therapy has been successfully used to relieve patients' withdrawal symptoms when cessation has been attempted. Nicotine replacement is available as a gum, patch, inhaler, and nasal spray. Bupropion, an antidepressant, is the first non-nicotine drug approved for smoking cessation. It blocks the neuronal uptake of serotonin and norepinephrine. Bupropion, like nicotine replacement therapy, is twice as effective as a placebo in smoking cessation.