Pharmacological therapies in smoking cessation: an evidence-based update

Smoking cessation presents a daunting challenge for clinicians; tobacco use impacts every major organ system and is responsible for considerable morbidity and mortality. Despite significant reductions in the rate of smoking over the past 50 years, tobacco use continues to burden the healthcare system. First-line therapies for smoking cessation include nicotine replacement, novel partial nicotinic agonists as well as antidepressant therapy. Herein, we review recent updates to the literature regarding nicotine replacement, bupropion, and varenicline. Re-emerging therapies such as cytisine are reviewed, as well as the novel concept of vaccination. Finally, the controversy surrounding electronic cigarettes and their debatable role in cessation therapy will be addressed as their popularity continues to grow.