[Medical therapy for smoking cessation]

Tobacco smoking is the leading cause of preventable morbidity and premature death. Physicians are in the unique position to promote smoking cessation and to support patients in quitting smoking is a key task for every single health care provider. Counselling smoking cessation is clearly shown to be both efficient and cost-effective in terms of years of live saved. Nicotine is highly addictive and to achieve long-term abstinence pharmacotherapy is frequently inevitable. Nicotine replacement therapy is efficacious and doubles the odds of permanently abstain from smoking. Further, strong evidence supports the use of buproprion, an atypical antidepressive agent, for quit smoking. Varenicline is the first medication specifically developed for smoking cessation. Varenicline is a partial agonist and antagonist at the nicotinic receptor that reduces craving, withdrawal symptoms and the reinforcing effect of smoking. This review summarises the current clinical data on the pharmacotherapy for smoking cessation and provides practical advice for daily clinical practice.