What is included in the long-term monitoring of patients with nicotine addiction?

Updated: Jul 16, 2018
  • Author: R Gregory Lande, DO, FACN; Chief Editor: Glen L Xiong, MD  more...
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Highly nicotine-dependent smokers may require initial therapy for 6 months or longer. Some individuals may require low-dose maintenance therapy for years.

Long-term follow-up is recommended because individuals who successfully quit smoking are at high risk for relapse. Relapse during the first year after achieving smoking cessation occurs in approximately 50% of patients, irrespective of therapeutic regimen. The changes in the central nervous system (eg, in neuron genetics, cell structure, and cell function) induced by smoking are not reversed by pharmacologic therapy.

The health care deliverer should make provisions for support, measurement of progress, and a mechanism to deal with relapse. For motivated patients who have failed smoking cessation, referral to an expert should be considered for treatment of a relapse. Controlled studies are required to help guide management of relapses and prolonged tapering periods. Immediately restarting nicotine medication might be helpful if a relapse occurs.

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