Department of Cardiology and Pneumology, University Hospital Gttingen, Gttingen, Germany.
CNS Drugs. 2011 May;25(5):371-82. doi: 10.2165/11590620-000000000-00000.
Promoting smoking cessation is among the key medical interventions aimed at reducing worldwide morbidity and mortality in this century. Both behavioural counselling and pharmacotherapy have been shown to significantly increase long-term abstinence rates, and combining the two treatment modalities is recommended. This article provides an update on pharmacotherapy for smoking cessation in the general population. Current first-line agents used to support quit attempts are nicotine replacement therapy (NRT), bupropion and varenicline. Research suggests that abstinence rates can be increased by combining different forms of NRT or simultaneously administering NRT and non-nicotine medications. New treatments targeting the nicotinic acetylcholine receptor as well as other pathophysiological pathways involved in nicotine addiction are being developed, with nicotine vaccines now being tested in phase III clinical trials. Among the numerous research topics currently addressed, pharmacogenetics and tailoring therapy to specific groups of smokers look most promising. However, substantial progress is unlikely to be made unless social gradients impeding effective treatment of all smokers are overcome. In addition, public smoking bans and reimbursement of medication costs are crucial in reducing the future burden of disease caused by smoking on a global level.
促进戒烟是本世纪降低全球发病率和死亡率的关键医学干预措施之一。行为咨询和药物治疗都已被证明可以显著提高长期戒烟率，因此推荐联合使用这两种治疗方法。本文提供了一般人群中戒烟药物治疗的最新信息。目前用于支持戒烟尝试的一线药物是尼古丁替代疗法（NRT）、安非他酮和伐尼克兰。研究表明，通过联合使用不同形式的 NRT 或同时给予 NRT 和非尼古丁药物，可以提高戒烟率。目前正在开发针对烟碱型乙酰胆碱受体以及尼古丁成瘾相关其他病理生理途径的新疗法，尼古丁疫苗现在正在进行 III 期临床试验。在目前正在研究的众多课题中，药物遗传学和针对特定吸烟人群的个体化治疗最有前景。然而，如果不能克服阻碍所有吸烟者接受有效治疗的社会梯度，就不太可能取得实质性进展。此外，公共场所禁烟和药物费用报销对于降低全球范围内因吸烟导致的未来疾病负担至关重要。
