| Summary: | Cigarette smoking is associated with cancer, respiratory disease, and cardiovascular disease. It is reported that 19% of Canadians aged 15 years and older were smokers in 2007. Each year, approximately 45,000 Canadians die from smoking. Cigarette smoking is considered the leading preventable cause of mortality. Smoking cessation reduces the risk of developing and dying from smoking-related diseases. Although approximately 70 percent of smokers plan to quit and over 40 percent of smokers report that they tried to quit, the long-term success rate of any unaided quit attempt is low, with only 3 to 7 percent of smokers who make an attempt still abstinent one year later. With optimal treatment, one-year cessation rates after a single quit attempt can exceed 30 percent. For most of smokers, smoking is both a learned behavior and a physical addiction to nicotine. The combination of counseling and pharmacologic therapies can produce higher quit rates than either one alone. Pharmacotherapy therapy for smoking cessation, including nicotine replacement therapy (NRT), bupropion, and varenicline, aims to reduce the symptoms of nicotine withdrawal, thereby making it easier for a smoker to stop the habitual use of cigarettes. In NRT, non-toxic forms of nicotine delivery systems are used to provide nicotine to maintain stimulation of nicotine receptors, thereby eliminating withdrawal symptoms and the sensations of craving for nicotine during a smoking cessation attempt. The objective of this review is to evaluate the clinical effectiveness of the newer NRT products including Nicorette QuickMist (or nicotine mouth spray), Nicorette ComboQuit (or combination of patches plus gum) or Nicorette Mini Lozenges (2 mg or 4 mg), use of supratherapeutic doses (high dose) of NRT, and use of NRTs to reduce smoking for those who do not plan to quit
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