Most smoking cessation therapies that are drug related contain nicotine and are referred to as “nicotine substitution products” or “nicotine replacement therapy” (NRT). The only other prescription medication to be approved by the U.S. Food and Drug Administration (FDA) for sale in the United States is marketed by SmithKleinGlaxo under the brand name Zyban.

These therapies are very popular and amount to more than $700 million a year in revenue for drug makers. Despite their popularity, NRT treatment plans offer about the same success rate as other smoking cessation methods, specifically about 20 percent to 25 percent. Another aspect of NRT therapy, such as chewing nicotine gum, is that some report they have stopped smoking but now are addicted to the gum.

NRT Therapy

The majority of drug smoking cessation therapies involve the use of NRTs. As of 2001, there were four forms approved by the FDA -- chewing gum, the transdermal skin patch, nasal spray, and inhaler. Both the nasal spray and inhaler are available only by prescription, but the gum and some brands of the patch can be purchased without a prescription, or “over the counter.”

Another form of NRT in the form of a nicotine eye drop reportedly is being researched and developed at Duke University at the Duke Center for Nicotine and Smoking Cessation Research by Jed Rose, Ph.D., director of the Duke Nicotine Research Program, research professor of biological psychiatry, and co-creator of the nicotine patch.

NRTs work by "replacing" the nicotine in a cigarette with another form to relieve some of the withdrawal symptoms people experience when they quit smoking. These treatments are meant to be used for about three months to help quitters get over the psychological aspects of quitting. Physicians generally do not suggest using these therapies longer than that. The cost of these products ranges from approximately $30 for a box of 48 pieces of the gum and about $30 a week for the patches.

Converted Antidepressant

The other major drug-related smoking cessation product is bupropion, which goes by the brand name Zyban – at least when it’s being prescribed for smokers. The same drug also is sold under the brand name Welbutrin when used to treat depression.

In fact, its use in smoking cessation grew out of statistics that showed a high percentage of people taking the drug for chronic depression also were able to quit smoking. Results from its use have been encouraging. There is evidence from studies that show as high as a 50 percent success rate, but that might not carry over into the real world, experts say. Zyban also can be used with NRT treatment to enhance a quitter’s chance of success.

Finally, one other medication has shown promise. Buspirone, brand name BuSpar, is a tranquilizer that may be effective in helping smokers deal with the anxiety associated with nicotine withdrawal.

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