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Tobacco dependence remains the primary preventable cause of death in the United States. It is a chronic disorder that often requires pharmacologic therapy, but counseling may be equally effective and can add to the effectiveness of any treatment for this indication.1,2 Abrupt cessation of smoking appears to be as effective as gradual reduction.3
NICOTINE — All FDA-approved nicotine replacement therapies (NRTs) deliver nicotine to nicotinic receptors in the central nervous system (CNS) in a lower dose and at a sub stantially slower rate than tobacco cigarettes. They increase smoking cessation rates by 50-70% and, in the short term, may decrease weight gain associated with smoking cessation.4,5 Nicotine undergoes first-pass metabolism, which limits its effectiveness in oral pill formulations. Nicotine... more
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