Pediatric Nicotine Abuse Medication

Updated: Apr 20, 2016
  • Author: Donna G Grigsby, MD; Chief Editor: Caroly Pataki, MD  more...
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Medication

Medication Summary

In adults with nicotine addiction, combination therapy with NRT and non-NRTs, particularly bupropion or other antidepressants, have been shown to double abstinence rates.

Nicotine replacement in adolescents has been shown to be safe, but studies have not demonstrated that these medications are effective in promoting long-term cessation in adolescents. As a result, the use of these medications is not recommended by the US Public Health Service in their most recently updated clinical practice guideline on treating tobacco use and dependence. [18]

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Nicotine replacement therapies

Class Summary

These agents help prevent nicotine withdrawal. They deliver nicotine systemically via oral or nasal mucosa or transdermal delivery systems. They are most effective for smoking cessation when used in conjunction with a support program, such as counseling, group therapy, or behavioral therapy.

Nicotine polacrilex gum/lozenge (Nicorette Gum, Commit Lozenge)

Nicotine is quickly absorbed through the oral mucosa. Closely approximates time course of plasma nicotine levels observed after cigarette smoking. Available as gum or lozenge.

Nicotine inhaler (Nicotrol Inhaler)

Quickly absorbed and closely approximates time course of plasma nicotine levels observed after cigarette smoking. Each inhaler cartridge delivers 4 mg of nicotine. Once activated, may be used over several min to simulate smoking, although the drug is generally absorbed from oral mucosa.

Nicotine nasal spray (Nicotrol NS)

Intranasal nicotine may closely approximate the time course of plasma nicotine levels observed after cigarette smoking.

Nicotine transdermal system (Nicotrol, Nicoderm CQ)

Transdermal patches are most appropriate for individuals who smoke more than 10 cigarettes each day.

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Non-nicotine replacement therapy

Class Summary

These agents modulate noradrenergic neurotransmission and increase smoking cessation rates.

Bupropion (Zyban)

Used in conjunction with a support group and/or behavioral counseling. Inhibits neuronal dopamine reuptake in addition to being a weak blocker of serotonin and norepinephrine reuptake.

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