Pharmacologic treatment of smoking is not a new idea.1 However, the search for effective pharmacologic treatments for smoking has increased dramatically in the last ten years due to the realization that smoking is a dependence disorder2; that behavioral strategies are not having a large effect on the prevalence of smoking3; and that nicotine dependence is becoming more prevalent in smokers due to a selection process.4 This latter process is occurring because smokers who are quitting appear to be smokers who are less dependent on nicotine. Thus, if this trend continues, in ten to 20 years the population of smokers will be almost exclusively smokers who are highly dependent on nicotine.
See also page 2863.
Nicotine gum was introduced in 1984 as the first proven pharmacologic aid for smoking cessation.5 Encouraged by this success, other nicotine replacement therapies, eg, nicotine patch6 and nicotine nasal spray,
Hughes JR. Clonidine, Depression, and Smoking Cessation. JAMA. 1988;259(19):2901–2902. doi:10.1001/jama.1988.03720190069036