[Current and future medical drugs for smoking cessation]

Tobacco smoking is the leading cause of preventable morbidity and mortality in the world. There are nearly 1, 3 billion users of nicotine and tobacco products worldwide while approximately 4, 9 millions of them die from smoking-related disease every year. Cigarette smoking is a highly addictive behavior. Pharmacotherapy can be useful to achieve long-term abstinence. Nicotine replacement products are widely employed and recommended by the World Health Organization. There is strong evidence for the efficacy of the atypical antidepressant Bupropion as therapy for smoking cessation. The partial nicotinic receptor agonist varenicline has recently been approved as treatment for nicotine addiction in Germany. Preliminary data from clinical trials have suggested that varenicline may be an effective therapy for tobacco dependence with minimal side effects. Clonidine and nortriptyline have demonstrated some efficacy but possible side effects may limit their use. Additionally both are not approved for smoking cessation in Germany. Other promising new therapeutic drugs include Rimonabant and nicotine vaccines. They will provide smokers additional options to assist in achieving smoking cessation. Treatment of psychological dependence in addition to physiological dependence, however, is a must for long-term abstinence. For this reason a successful smoking cessation intervention requires besides pharmacological treatments motivational counseling and behavioral interventions.