Abstract
ABSTRACT
Introduction: Tobacco use remains a major cause of morbidity and mortality in the United States. Over the past several decades, there has been a steady decline in tobacco use, however overall use remains unacceptably high. Despite recommendations to treat people with tobacco use disorder with smoking cessation medications (SCMs), prescriptions for SCMs remain low.
Methods: A PubMed search was conducted using search terms “adult”, “smoking cessation”, “medication”, “varenicline”, “nicotine”, and “bupropion”. Filters included publication dates within ten years, and full text. Search results yielded 109 articles. Thirteen articles were selected for the review. The articles chosen either discussed prescribing patterns of SCMs, or addressed neuropsychiatric adverse events (NPAE), or cardiovascular safety concerns. Articles discussing the use of e-cigarettes for smoking cessation were excluded.
Results: Low rates of prescriptions for SCMs were noted following Food and Drug Administration (FDA) black box warnings in 2009 and an FDA safety announcement in 2011. Patients with psychiatric disease and chronic medical conditions are prescribed SCMs at lower rates than healthier people.
Conclusion: Concerns from health care providers (HCPs) include the possibility of NPAE, and cardiovascular adverse effects with varenicline, and NPAE with bupropion. Despite a pivotal study in 2016 which led to the removal of the black box warnings, and multiple later studies showing safety and efficacy, SCMs remain underutilized. Education for HCPs is needed to provide updates on evidence related to SCMs, and guidelines based on evidence.
Recommended Citation
Pratt, Jesse
(2026)
"Low Rates of Smoking Cessation Medication Prescriptions and Evidence to Support Increased Medication Utilization,"
SIU Journal of Medical Science Scholarly Works: Vol. 3:
Iss.
1, Article 8.
Available at:
https://opensiuc.lib.siu.edu/jmssw/vol3/iss1/8