Abstract
Background: Pharmacologic therapies have an important role in the success of interventions for smoking cessation. This study aims to determine the efficacy of several pharmacologic treatments in patients who applied to a smoking cessation clinic.
 Methods: This retrospective study includes 422 patients who presented to our smoking cessation clinic between January 2010 and June 2013, used the pharmacologic treatment as prescribed and completed the one-year follow-up period. All patients were assessed using the Fagerström Test for Nicotine Dependence (FTND) and received both behavioral therapy and pharmacotherapy. Patients’ smoking status at one year was assessed by telephone interview.
 Results: The patients were 24.3% female (103/422) and 75.7% male (319/422) with a mean age of 38 ± 10 years. Patients were divided into three groups: varenicline (166 patients), bupropion (148 patients) and nicotine replacement therapy (108 patients). The smoking cessation rates of these groups were 32.5%, 23% and 52.8%, respectively, and were statistically significant (p < 0.001). The overall success rate was 35%. Further analysis revealed that pharmacologic therapy (p < 0.001) and gender (p = 0.01) were factors that showed statistically significant effects on smoking cessation rates. Males had higher success rates than females. The overall relapse rate was 21.6% and the bupropion group showed the highest relapse rate among treatment groups. Lack of determination emerged as the most important factor leading to relapse.
 Conclusion: Nicotine replacement therapy was found to be more effective at promoting abstinence from smoking than other pharmacologic therapies.
Highlights
Pharmacologic therapies have an important role in the success of interventions for smoking cessation
The antihypertensive medication clonidine and the tricyclic antidepressant nortriptyline are sometimes used as second-line agents for smoking cessation, but their use is not Food and Drug Administration (FDA) approved for this indication [7]
This study showed that, besides behavioral therapy, pharmacologic treatment is important in smoking cessation success rates
Summary
Pharmacologic therapies have an important role in the success of interventions for smoking cessation. Smoking cessation significantly improves life expectancy, decreases morbidity, and reduces healthcare costs associated with smokingrelated conditions [3]. Interventions that include both counseling and pharmacotherapy appear to be the most effective, and success is more likely with more intensive interventions [4,5]. There are several pharmacological interventions available to aid smoking cessation [6]. Clinical trials have demonstrated statistically significant improvement in smoking cessation with varenicline and bupropion [9,10]
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