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Pharmacotherapy, including nicotine replacement therapy (NRT) and prescription drugs, is effective in treating tobacco dependence, increasing quit rates, and increasing long-term smoking abstinence rates in clinical trials.

More than 100 studies have concluded that NRT is an efficacious and safe tobacco dependence treatment. These studies have compared nicotine gum, nicotine patch, nicotine inhaler, nicotine nasal spray, and nicotine lozenge to placebo. They provide overwhelming support for the notion that, at least in clinical trials, all aforementioned NRT products increase long term abstinence rates. To that end, in 2009, the WHO added NRT in the form of the gum and patch to its Model List of Essential Medicines in recognition of those therapies’ established efficacy and cost-effectiveness.

However, the evidence of the impact of pharmacotherapy on population smoking cessation trends is mixed. Small population based studies, like a 2012 study in Massachusetts have failed to find a positive effect of NRT use in promoting cessation. Additionally, millions of successful quit attempts were undertaken in the years before NRT was released onto the market and even today, more smokers quit without assistance from pharmacotherapy than with chemical assistance. However, a population-based simulation model of proposed tobacco control policies in Italy attributes nearly one-fifth of future cessation to the implementation of comprehensive cessation coverage and treatment policies, indicating that cessation therapy still play an integral role in a comprehensive tobacco control policy framework.

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