Terapia farmacológica de primera línea en cesación tabáquica

Abstract

The current standard for smoking cessation is combined psychological and pharmacological treatment. Administering a drug to stop smoking in isolation (8-10% abstinence per year) is not the same as using it together with support and behavioral intervention (more than 30% abstinence). The fundamental reason drugs are used in the process of quitting smoking is because it has been proven that their use not only mitigates withdrawal symptoms but also increases long term quit rates (6-12 months). Varenicline, nicotine replacement therapy (NRT), bupropion and cytisine are all more effective than placebo. In very dependent smokers, a combination of drugs is recommended, with those associations containing varenicline being more effective. In special populations (chronic respiratory diseases, cardiovascular diseases or psychiatric pathology), varenicline alone or combined with NRT is recommended as the first option. Finally, it is important to highlight that the fact that a previous unsuccessful attempt to stop smoking with a certain drug is not a contraindication for its subsequent use since success depends on many factors, such as; correct usage of the drug, motivational stage, presence of environmental obstacles and a firm decision to quit smoking, among others.