At this time there are three main pharmacologic approaches to smoking cessation: nicotine replacement therapy (NRT), varenicline, and buproprion. NRT substitutes the nicotine from cigarettes with a sustained nicotine replacement which can then be tapered over several weeks. Varenicline is a partial nicotinic receptor agonist that minimizes nicotine craving and withdrawal. Buproprion acts through a different mechanism via inhibition of catecholamine (noradrenaline and dopamine) reuptake to improve quit rates. It is likely that there are different genetic profiles that identify who will best respond to one pharmacologic treatment or another. A potential promise of the study of the genetics of nicotine dependence is that we may gain insights into these profiles.
