New and emerging treatments in smoking cessation

• Objective: To review recently approved and emerging medications for smoking cessation. • Methods: Studies on newer smoking cessation aids were identified using MEDLINE (1996-2007), the Society for Research on Nicotine and Tobacco abstracts database, and the U.S. Patents and Trademark Office database. All randomized controlled trials evaluating 1 or more medications used in smoking cessation (including vaccines) were included. Phase 1 and animal studies were excluded. • Results: Varenicline has been effective in smoking cessation despite the unquantified risk of serious psychiatric effects. Rimonabant appears to be effective for smoking cessation and possibly relapse prevention and is generally well tolerated. Nicotine vaccines, mecamylamine, topiramate, and selegiline all appear effective for use in smoking cessation in preliminary trials, but additional studies are needed to confirm these findings both in the short and long term. • Conclusion: Currently available first-line treatments for smoking cessation include nicotine replacement (eg, nicotine patch, nicotine gum), bupropion, and varenicline and have proven efficacy in published studies. Several treatments currently under study appear promising.