FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 333:1196-1203 November 2, 1995 Number 18 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

	Full Text PDF Purchase this article Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Cigarettes are among the most addicting products known, and the vast majority of people who quit smoking relapse within days.^1,2 In the United States, less than 10 percent of the nearly 20 million people who quit smoking for a day remain abstinent one year later.³ Thus, only 2 to 3 percent of smokers become nonsmokers each year.³ Medications that contain nicotine enable health care providers to increase markedly the ability of their patients to achieve and sustain tobacco abstinence. This review summarizes the scientific rationale for nicotine medications, to help clinicians optimize their use.

Pathophysiology of Nicotine Addiction

Clinical Course

One third to one half of . . . [Full Text of this Article]

Pharmacokinetic Considerations

Nicotine Medications

Description

Pharmacokinetics

Efficacy

Mechanisms of Action and Limitations of Nicotine Medications

Indications and Applications

Diagnosis and Dosing

Instructions and Follow-Up

Combined Therapy with Nicotine Polacrilex and Transdermal Nicotine

Contraindications, Adverse Effects, and Special Groups of Patients

Contraindications and Adverse Effects

Dependence

Pregnant Patients

Patients with Cardiovascular Diseases

Adolescent Smokers

Patients with Multiple Psychiatric Diagnoses

Drug Interactions

Conclusions

Source Information

From the Clinical Pharmacology Branch, Addiction Research Center, Intramural Research Program, National Institute on Drug Abuse, and the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine — both in Baltimore.

Address reprint requests to Dr. Henningfield at the NIDA Addiction Research Center, P.O. Box 5180, Baltimore, MD 21224.

References

This article has been cited by other articles:

• Britton, J. (2008). Should doctors advocate snus and other nicotine replacements? Yes. BMJ 336: 358-358 [Full Text]  
• Sullivan, K. M ., Seed, S. M., DeBellis, R. J. (2007). State of the Art Reviews: Smoking Cessation: A Review of Treatment Considerations. AMERICAN JOURNAL OF LIFESTYLE MEDICINE 1: 201-213 [Abstract]  
• Theadom, A., Cropley, M. (2006). Effects of preoperative smoking cessation on the incidence and risk of intraoperative and postoperative complications in adult smokers: a systematic review.. Tobacco Control 15: 352-358 [Abstract] [Full Text]  
• Najem, B., Houssiere, A., Pathak, A., Janssen, C., Lemogoum, D., Xhaet, O., Cuylits, N., van de Borne, P. (2006). Acute Cardiovascular and Sympathetic Effects of Nicotine Replacement Therapy. Hypertension 47: 1162-1167 [Abstract] [Full Text]  
• Henningfield, J. E., Fant, R. V., Buchhalter, A. R., Stitzer, M. L. (2005). Pharmacotherapy for Nicotine Dependence. CA Cancer J Clin 55: 281-299 [Abstract] [Full Text]  
• Rothman, R. B., Blough, B. E., Woolverton, W. L., Anderson, K. G., Negus, S. S., Mello, N. K., Roth, B. L., Baumann, M. H. (2005). Development of a Rationally Designed, Low Abuse Potential, Biogenic Amine Releaser That Suppresses Cocaine Self-Administration. J. Pharmacol. Exp. Ther. 313: 1361-1369 [Abstract] [Full Text]  
• Lerman, C., Patterson, F., Berrettini, W. (2005). Treating Tobacco Dependence: State of the Science and New Directions. JCO 23: 311-323 [Abstract] [Full Text]  
• Lerman, C., Kaufmann, V., Rukstalis, M., Patterson, F., Perkins, K., Audrain-McGovern, J., Benowitz, N. (2004). Individualizing Nicotine Replacement Therapy for the Treatment of Tobacco Dependence: A Randomized Trial. ANN INTERN MED 140: 426-433 [Abstract] [Full Text]  
• Molyneux, A. (2004). Nicotine replacement therapy. BMJ 328: 454-456 [Full Text]  
• Shiffman, S, Hughes, J R, Pillitteri, J L, Burton, S L (2003). Persistent use of nicotine replacement therapy: an analysis of actual purchase patterns in a population based sample. Tobacco Control 12: 310-316 [Abstract] [Full Text]  
• Breland, A B, Evans, S E, Buchhalter, A R, Eissenberg, T (2002). Acute effects of AdvanceTM: a potential reduced exposure product for smokers. Tobacco Control 11: 376-378 [Abstract] [Full Text]  
• Shiffman, S., Dresler, C. M., Hajek, P., Gilburt, S. J. A., Targett, D. A., Strahs, K. R. (2002). Efficacy of a Nicotine Lozenge for Smoking Cessation. Arch Intern Med 162: 1267-1276 [Abstract] [Full Text]  
• Dempsey, D., Jacob, P. III, Benowitz, N. L. (2002). Accelerated Metabolism of Nicotine and Cotinine in Pregnant Smokers. J. Pharmacol. Exp. Ther. 301: 594-598 [Abstract] [Full Text]  
• Ueda, K, Kawachi, I, Nakamura, M, Nogami, H, Shirokawa, N, Masui, S, Okayama, A, Oshima, A (2002). Cigarette nicotine yields and nicotine intake among Japanese male workers. Tobacco Control 11: 55-60 [Abstract] [Full Text]  
• ONCKEN, C. A., PBERT, L., OCKENE, J. K., ZAPKA, J., STODDARD, A. (2000). Nicotine Replacement Prescription Practices of Obstetric and Pediatric Clinicians. Obstet Gynecol 96: 261-265 [Abstract] [Full Text]  
• Okuyemi, K. S., Ahluwalia, J. S., Harris, K. J. (2000). Pharmacotherapy of Smoking Cessation. Arch Fam Med 9: 270-281 [Abstract] [Full Text]  
• Henningfield, J. E (2000). Tobacco dependence treatment: scientific challenges; public health opportunities. Tobacco Control 9: i3-10 [Full Text]  
• Djordjevic, M. V., Stellman, S. D., Zang, E. (2000). Doses of Nicotine and Lung Carcinogens Delivered to Cigarette Smokers. JNCI J Natl Cancer Inst 92: 106-111 [Abstract] [Full Text]  
• Benowitz, N. L., Zevin, S., Jacob III, P. (1998). Suppression of Nicotine Intake During Ad Libitum Cigarette Smoking by High-Dose Transdermal Nicotine. J. Pharmacol. Exp. Ther. 287: 958-962 [Abstract] [Full Text]  
• Gunn, N., White, C., Srinivasan, R. (1998). Primary Care as Harm Reduction for Injection Drug Users. JAMA 280: 1191-1195 [Full Text]  
• Henningfield, J. E, Benowitz, N. L, Slade, J., Houston, T. P, Davis, R. M, Deitchman, S. D (1998). Reducing the addictiveness of cigarettes. Tobacco Control 7: 281-293 [Abstract] [Full Text]  
• Hieda, Y., Keyler, D. E., Vandevoort, J. T., Kane, J. K., Ross, C. A., Raphael, D. E., Niedbalas, R. S., Pentel, P. R. (1997). Active Immunization Alters the Plasma Nicotine Concentration in Rats. J. Pharmacol. Exp. Ther. 283: 1076-1081 [Abstract] [Full Text]  
• Woolf, A., Burkhart, K., Caraccio, T., Litovitz, T. (1997). Childhood Poisoning Involving Transdermal Nicotine Patches. Pediatrics 99: e4-e4 [Abstract] [Full Text]  
• Moore, G. E., Nadarajan, V. S., Papagiannis, A. (1997). The Food and Drug Administration's Regulation of Tobacco Products. NEJM 336: 880-882 [Full Text]  
• Joseph, A. M., Norman, S. M., Ferry, L. H., Prochazka, A. V., Westman, E. C., Steele, B. G., Sherman, S. E., Cleveland, M., Antonuccio, D. O., Hartman, N., McGovern, P. G. (1996). The Safety of Transdermal Nicotine as an Aid to Smoking Cessation in Patients with Cardiac Disease. NEJM 335: 1792-1798 [Abstract] [Full Text]  
• Califano, J. A. (1995). The Wrong Way to Stay Slim. NEJM 333: 1214-1216 [Full Text]