124. Treatment Recommendations: Medications (Continued)

Treating Tobacco Use and Dependence: 2008 Update
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Clinical guidelines for prescribing medication for treating tobacco use and dependence

Who should receive medication for tobacco use? Are there groups of smokers for whom medication has not been shown to be effective? All smokers trying to quit should be offered medication, except where contraindicated or for specific populations for which there is insufficient evidence of effectiveness (i.e., pregnant women, smokeless tobacco users, light smokers and adolescents.
What are the first-line medications recommended in this Guideline update? All seven of the FDA-approved medications for treating tobacco use are recommended: bupropion SR, nicotine gum, nicotine inhaler, nicotine lozenge, nicotine nasal spray, the nicotine patch and varenicline. The clinician should consider the first-line medications shown to be more effective than the nicotine patch alone: 2 mg/day varenicline or the combination of long-term nicotine patch use + ad libitum NRT. Unfortunately, there are no well accepted algorithms to guide optimal selection among the first-line medications.

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Page last reviewed October 2014
Internet Citation: 124. Treatment Recommendations: Medications (Continued). October 2014. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/tobacco/clinicians/presentations/2008update-full/slide124.html