User:J. Cucchi/sandbox

Etiology of smoking
Tobacco smoking as self-medication

Counseling
Recording smoking status as a vital sign increases the frequency of brief advice to patients by physicians.

Motivational interviewing may help smoking cessation.

Demonstration of damage to lungs
In general, informing patients of their lung function as measured by spirometry does not increase smoking cession according to a systematic review by the U.S. Preventive Services Task Force  (USPSTF). However, in a more recent randomized controlled trial, patients in the group who were informed of their 'lung age' were more likely to stop smoking. However, in this trial, "People with worse spirometric lung age were no more likely to have quit than those with normal lung age in either group".

Bupropion
Bupropion is both an adrenergic uptake inhibitor and a dopamine uptake inhibitor and can help smoking cessation, including adding to the effective of nicotine replacement.

Varenicline
Varenicline, a partial agonist at the α4β2 nicotinic acetylcholine receptor, may be more effective than bupropion ; however, bupropion is a generic drug. Varenicline is probably better than the nicotine patch; however, the only study was not blinded and was industry sponsored.

The Food and Drug Administration of the United States has issued an advisory for varenicline and psychiatric disease.

Nicotine replacement
A systematic reviews of selected medications including nicotine replacement found that the odds ratios for quitting with nicotine are:
 * Spray, 2.37
 * Inhaler, 2.18
 * Patch, 1.88
 * Gum, 1.65

Rimonabant
Rimonabant, a selective type 1 cannabinoid (CB1) receptor antagonist, improves smoking cessation and moderate weight gain associated with smoking cessation according to a meta-analysis of randomized controlled trials by the Cochrane Collaboration. However, "there is current concern (August 2007) over rates of depression and suicidal thoughts in people taking rimonabant for weight control."

Atomoxetine
Addiction is reinforced by the fear of experiencing the adverse effects associated with the cessation of the drug. Smoking withdrawal causes cognitive deficits analogous to attention deficit hyperactivity disorder, an observation which prompted researchers to test the hypothesis that drugs that ameliorate ADHD facilitate smoking cessation. In confirmation of this hypothesis, it was shown that atomoxetine, a norepinephrine reuptake inhibitor that is approved by the FDA to treat the symptoms of ADHD, dose-dependently reversed congnitive deficits in an animal model of nicotine withdrawal. Atomoxetine is not indicated at this time as a medication to treat the ADHD-like symptoms of smoking cessation.

Incentives
Financial incentives to either smokers or their health care providers may increase rates of smoking cessation.

Adverse effects
Smoking cessation may lead to weight gain, which may lead to diabetes mellitus type 2.