STAGE 4. Selecting the theoretical approach

What steps should be completed?

Step 1: Select the theoretical approach or approaches on which the intervention will be based

PHARMACOLOGICAL TREATMENT FOR NICOTINE DEPENDENCE

In general, except in special circumstances (pregnancy, adolescence, etc.), smokers who wish to cease smoking are recommended first-line pharmacological treatment. There are various pharmacological treatments of this type:

• Nicotine replacement therapies. These consist of administering nicotine by a different route from that of a cigarette and in sufficient quantity to reduce the withdrawal syndrome. Its objective is to minimise withdrawal syndrome symptoms, which are the cause of high relapse rates in the first few days of treatment. Nicotine replacement therapy is gradually reduced after a period of acute abstinence. Up to six types of nicotine substitutes are used (gum, patch, oral inhaler, nasal spray, sublingual tablets and sucking tablets), all with similar effectiveness.
• Antidepressants. These are frequently used to treat smoking, bupropion (prolonged release) being the most widely used due to its simultaneous dopaminergic and noradrenergic effects that can simulate the effects of nicotine,  reducing the typical symptoms of abstinence.
• Other pharmacological treatments. Other medication that acts as a partial nicotine agonist has also been used in recent years.

Pharmacological treatments for smoking are often accompanied by interventions such as health counselling, brief interventions and specialised psychological treatments. The combined use of pharmacological therapies and health advice and/or psychological treatment significantly increases treatment effectiveness.