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Smoking Cessation and Continued Risk in Cancer Patients

Treatment

Different ways to stop smoking are effective for different patients. Some smokers can quit with the help of counseling, while others may need nicotine replacement therapy or non-nicotine medicines to help them quit. Since patients can improve their health in many ways by quitting smoking, medicines are often prescribed with careful monitoring to help them succeed.

Nicotine Replacement Therapies

Nicotine replacement therapy may help with the withdrawal symptoms that patients experience when trying to stop smoking. Nicotine products include:

A physician should be consulted before starting any form of treatment, and the following groups should take special precautions:

Non-nicotine Medicines

Non-nicotine medicines that have been studied to help people quit smoking include:

The FDA has directed manufacturers of bupropion and varenicline to add a boxed warning about the risk of depression, suicide, and other psychiatric events in patients who take these drugs, including:

These events have been reported in patients with or without a history of psychiatric illness. It is not known whether nicotine withdrawal is a factor in these psychiatric events. Fluoxetine has a boxed warning about an increased risk of suicide in young adults aged less than 25 years. (See the Depression and Suicide section in the PDQ summary on Pediatric Supportive Care.)

All patients taking these drugs, especially those with a history of psychiatric illness, should be closely monitored during smoking cessation.

The FDA advises that the important health benefits of quitting smoking should be weighed against the small but serious risk of problems with the use of these drugs.