There are seven FDA-approved medications for smoking cessation (Table 2). While all FDA approved medications have been shown in randomized trials to be more effective than placebo, two are especially effective: a) varenicline and b) combination NRT (the nicotine patch with an acute form of nicotine therapy such as the nicotine gum, lozenge, inhaler or spray). A meta-analysis3 of 83 randomized clinical trials examined the effectiveness of cessation medications in producing abstinence at 6-months following treatment; most cessation medications (e.g., the nicotine patch, gum, lozenge, nasal spray, inhaler, and bupropion) approximately doubled the odds of a patient achieving abstinence (used as per guidance in Table 2). The estimated 6-month abstinence rate amongst patients getting placebo was about 14%, versus 19–26% across most pharmacotherapies (some studies had counseling in all study conditions, so these effectiveness rates reflect some counseling benefit). However, varenicline and combination NRT produced estimated abstinence rates of 33 and 37%, respectively3, rates that were significantly higher than a representative monotherapy such as the nicotine patch. Because both combination NRT and varenicline produce higher abstinence rates than other pharmacotherapies3,37,
