Document Detail

Methods for smoking cessation and treatment of nicotine dependence.
MedLine Citation:
PMID:  16878254     Owner:  NLM     Status:  MEDLINE    
Smoking is related to 30% of cancer deaths. It is a risk factor for respiratory tract, esophagus, stomach, pancreas, uterine cervix, kidney and bladder carcinomas. Nicotine induces tolerance and addiction by acting on the central dopaminergic pathways, thus leading to pleasure and reward sensations within the limbic system. It stimulates the central nervous system (CNS), enhances alertness and reduces the appetite. A 50% reduction of nicotine consumption may trigger withdrawal symptoms in addicted individuals: anxiety, anger, sleep disorders, hunger, cognitive dysfunction and cigarette craving. Medical advice is the cornerstone of smoking cessation. Pharmacotherapy of nicotine addiction comprises first-line (bupropion and nicotine replacement therapy) and second-line (clonidine and nortriptyline) drugs. Bupropion is a non-tricyclic antidepressant that inhibits dopamine uptake, whose contraindications are: epilepsy, eating disorders, uncontrolled hypertension, recent alcohol abstinence and current therapy with MAO inhibitors. Nicotine replacement therapy can be done with patches or gums. Counseling groups and behavioral interventions are efficacious. The effects of acupuncture on smoking cessation are not fully elucidated. Prompt smoking cessation or gradual reduction strategies have similar success rates.
Aracy Pereira Silveira Balbani; Jair Cortez Montovani
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Brazilian journal of otorhinolaryngology     Volume:  71     ISSN:  1808-8694     ISO Abbreviation:  -     Publication Date:    2005 Nov-Dec
Date Detail:
Created Date:  2006-07-31     Completed Date:  2007-02-08     Revised Date:  2008-10-06    
Medline Journal Info:
Nlm Unique ID:  101207337     Medline TA:  Braz J Otorhinolaryngol     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  820-7     Citation Subset:  IM    
Discipline of Otorhinolaryngology and Head and Neck Surgery, Medical School Botucatu, Universidade Estadual Paulista Júlio de Mesquita Filho, UNESP.
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MeSH Terms
Adrenergic alpha-Agonists / administration & dosage
Antidepressive Agents / administration & dosage
Bupropion / administration & dosage
Clonidine / administration & dosage
Cognitive Therapy
Combined Modality Therapy
Nicotine / administration & dosage
Nicotinic Agonists / administration & dosage
Nortriptyline / administration & dosage
Smoking / drug therapy,  psychology,  therapy*
Smoking Cessation / methods*,  psychology
Substance Withdrawal Syndrome / drug therapy*,  psychology
Reg. No./Substance:
0/Adrenergic alpha-Agonists; 0/Antidepressive Agents; 0/Nicotinic Agonists; 34841-39-9/Bupropion; 4205-90-7/Clonidine; 54-11-5/Nicotine; 72-69-5/Nortriptyline

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