Tobacco dependence and withdrawal: Science base, challenges and opportunities for pharmacotherapy

Jack E. Henningfield, Saul Shiffman, Stuart G. Ferguson, Ellen R. Gritz

Research output: Contribution to journalArticle

Abstract

Several pharmacotherapies for tobacco dependence and withdrawal have been approved by the Food and Drug Administration to aid smoking cessation. These medicines double to triple the odds of cessation compared to placebo, with the diversity in chemical entity (e.g., nicotine, varenicline, bupropion) and route (e.g., nicotine gum and transdermal patch) providing options for people who find a given medication unacceptable or ineffective. Treatments in development include vaccines, combinations of existing products, and new indications, such as reduced tobacco use and exposure. These therapies have been developed on the foundation of research on the neuropharmacology of tobacco dependence and withdrawal. Ongoing research is expected to contribute to more efficacious use of existing therapies and the development of new approaches. This article addresses these developments as well as the challenges to medication development. Challenges include understanding the population-based and individual differences in the vulnerability to dependence and responsiveness to various treatment options, which could contribute to effective treatment to patient matching. Research on the CNS effects of administration and withdrawal of nicotine and other tobacco product constituents is expanding, providing the basis for more effective therapeutic approaches and new medications development. Additionally, whereas medications are approved on the basis of standardized assessments of efficacy and safety in clinical trials, the public health impact of medications depends also on their appeal to smokers and their effectiveness in actual use settings. Research on more effective medication use along with policies that support improved access and utilization are vital to conquering the tobacco epidemic.

Original languageEnglish (US)
Pages (from-to)1-16
Number of pages16
JournalPharmacology and Therapeutics
Volume123
Issue number1
DOIs
StatePublished - Jul 2009

Fingerprint

Tobacco Use Disorder
Drug Therapy
Nicotine
Research
Therapeutics
Neuropharmacology
Tobacco Use Cessation Products
Combined Vaccines
Bupropion
Tobacco Use
Smoking Cessation
United States Food and Drug Administration
Individuality
Tobacco Products
Tobacco
Public Health
Placebos
Clinical Trials
Safety
Population

Keywords

  • brain
  • brain imaging
  • bupropion
  • drug
  • efficacy
  • epidemiology
  • gum
  • inhaler
  • lozenge
  • mechanism
  • nasal
  • nicotine
  • nicotine replacement therapy
  • patch
  • pharmacotherapy
  • policy
  • receptors
  • tobacco
  • treatment
  • varenicline
  • withdrawal

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

Cite this

Tobacco dependence and withdrawal : Science base, challenges and opportunities for pharmacotherapy. / Henningfield, Jack E.; Shiffman, Saul; Ferguson, Stuart G.; Gritz, Ellen R.

In: Pharmacology and Therapeutics, Vol. 123, No. 1, 07.2009, p. 1-16.

Research output: Contribution to journalArticle

Henningfield, Jack E. ; Shiffman, Saul ; Ferguson, Stuart G. ; Gritz, Ellen R. / Tobacco dependence and withdrawal : Science base, challenges and opportunities for pharmacotherapy. In: Pharmacology and Therapeutics. 2009 ; Vol. 123, No. 1. pp. 1-16.
@article{2deae22307de4ffaa7e652394996b351,
title = "Tobacco dependence and withdrawal: Science base, challenges and opportunities for pharmacotherapy",
abstract = "Several pharmacotherapies for tobacco dependence and withdrawal have been approved by the Food and Drug Administration to aid smoking cessation. These medicines double to triple the odds of cessation compared to placebo, with the diversity in chemical entity (e.g., nicotine, varenicline, bupropion) and route (e.g., nicotine gum and transdermal patch) providing options for people who find a given medication unacceptable or ineffective. Treatments in development include vaccines, combinations of existing products, and new indications, such as reduced tobacco use and exposure. These therapies have been developed on the foundation of research on the neuropharmacology of tobacco dependence and withdrawal. Ongoing research is expected to contribute to more efficacious use of existing therapies and the development of new approaches. This article addresses these developments as well as the challenges to medication development. Challenges include understanding the population-based and individual differences in the vulnerability to dependence and responsiveness to various treatment options, which could contribute to effective treatment to patient matching. Research on the CNS effects of administration and withdrawal of nicotine and other tobacco product constituents is expanding, providing the basis for more effective therapeutic approaches and new medications development. Additionally, whereas medications are approved on the basis of standardized assessments of efficacy and safety in clinical trials, the public health impact of medications depends also on their appeal to smokers and their effectiveness in actual use settings. Research on more effective medication use along with policies that support improved access and utilization are vital to conquering the tobacco epidemic.",
keywords = "brain, brain imaging, bupropion, drug, efficacy, epidemiology, gum, inhaler, lozenge, mechanism, nasal, nicotine, nicotine replacement therapy, patch, pharmacotherapy, policy, receptors, tobacco, treatment, varenicline, withdrawal",
author = "Henningfield, {Jack E.} and Saul Shiffman and Ferguson, {Stuart G.} and Gritz, {Ellen R.}",
year = "2009",
month = "7",
doi = "10.1016/j.pharmthera.2009.03.011",
language = "English (US)",
volume = "123",
pages = "1--16",
journal = "Pharmacology and Therapeutics",
issn = "0163-7258",
publisher = "Elsevier Inc.",
number = "1",

}

TY - JOUR

T1 - Tobacco dependence and withdrawal

T2 - Science base, challenges and opportunities for pharmacotherapy

AU - Henningfield, Jack E.

AU - Shiffman, Saul

AU - Ferguson, Stuart G.

AU - Gritz, Ellen R.

PY - 2009/7

Y1 - 2009/7

N2 - Several pharmacotherapies for tobacco dependence and withdrawal have been approved by the Food and Drug Administration to aid smoking cessation. These medicines double to triple the odds of cessation compared to placebo, with the diversity in chemical entity (e.g., nicotine, varenicline, bupropion) and route (e.g., nicotine gum and transdermal patch) providing options for people who find a given medication unacceptable or ineffective. Treatments in development include vaccines, combinations of existing products, and new indications, such as reduced tobacco use and exposure. These therapies have been developed on the foundation of research on the neuropharmacology of tobacco dependence and withdrawal. Ongoing research is expected to contribute to more efficacious use of existing therapies and the development of new approaches. This article addresses these developments as well as the challenges to medication development. Challenges include understanding the population-based and individual differences in the vulnerability to dependence and responsiveness to various treatment options, which could contribute to effective treatment to patient matching. Research on the CNS effects of administration and withdrawal of nicotine and other tobacco product constituents is expanding, providing the basis for more effective therapeutic approaches and new medications development. Additionally, whereas medications are approved on the basis of standardized assessments of efficacy and safety in clinical trials, the public health impact of medications depends also on their appeal to smokers and their effectiveness in actual use settings. Research on more effective medication use along with policies that support improved access and utilization are vital to conquering the tobacco epidemic.

AB - Several pharmacotherapies for tobacco dependence and withdrawal have been approved by the Food and Drug Administration to aid smoking cessation. These medicines double to triple the odds of cessation compared to placebo, with the diversity in chemical entity (e.g., nicotine, varenicline, bupropion) and route (e.g., nicotine gum and transdermal patch) providing options for people who find a given medication unacceptable or ineffective. Treatments in development include vaccines, combinations of existing products, and new indications, such as reduced tobacco use and exposure. These therapies have been developed on the foundation of research on the neuropharmacology of tobacco dependence and withdrawal. Ongoing research is expected to contribute to more efficacious use of existing therapies and the development of new approaches. This article addresses these developments as well as the challenges to medication development. Challenges include understanding the population-based and individual differences in the vulnerability to dependence and responsiveness to various treatment options, which could contribute to effective treatment to patient matching. Research on the CNS effects of administration and withdrawal of nicotine and other tobacco product constituents is expanding, providing the basis for more effective therapeutic approaches and new medications development. Additionally, whereas medications are approved on the basis of standardized assessments of efficacy and safety in clinical trials, the public health impact of medications depends also on their appeal to smokers and their effectiveness in actual use settings. Research on more effective medication use along with policies that support improved access and utilization are vital to conquering the tobacco epidemic.

KW - brain

KW - brain imaging

KW - bupropion

KW - drug

KW - efficacy

KW - epidemiology

KW - gum

KW - inhaler

KW - lozenge

KW - mechanism

KW - nasal

KW - nicotine

KW - nicotine replacement therapy

KW - patch

KW - pharmacotherapy

KW - policy

KW - receptors

KW - tobacco

KW - treatment

KW - varenicline

KW - withdrawal

UR - http://www.scopus.com/inward/record.url?scp=65849445884&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=65849445884&partnerID=8YFLogxK

U2 - 10.1016/j.pharmthera.2009.03.011

DO - 10.1016/j.pharmthera.2009.03.011

M3 - Article

C2 - 19362108

AN - SCOPUS:65849445884

VL - 123

SP - 1

EP - 16

JO - Pharmacology and Therapeutics

JF - Pharmacology and Therapeutics

SN - 0163-7258

IS - 1

ER -