Smoking cessation
Discontinuation of tobacco use in adults with nicotine dependence. Evidence-based methods: nicotine replacement therapy, varenicline, bupropion, and behavioral counseling.
ICD-10 F172 drugs
Also known as: Quit smoking
Drugs used for this condition
- ABupropionFirst line · Other antidepressants (NDRI)Per USPSTF 2021 and Cochrane 2023, bupropion (Zyban 150 mg twice daily) is first-line for smoking cessation alongside varenicline and nicotine replacement therapy. Doubles the chance of sustained abstinence vs placebo. Start 1–2 weeks before quit date; continue for 7–12 weeks.
- ANicotineFirst line · Nicotine replacement therapy for tobacco dependenceFirst-line for smoking cessation per NICE NG209 (2021) and USPSTF 2021. Combining long-acting (patch 14 or 21 mg over 24 or 16 hours) and short-acting (gum 2 or 4 mg as needed, lozenge, nasal or oral spray) raises efficacy over monotherapy. Course 8–12 weeks with gradual dose reduction. Efficacy comparable to bupropion and varenicline; combined with behavioral support – best outcomes.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit