GRADUAL NICOTINE TAPERING STRATEGIES FOR SMOKING CESSATION: CHALLENGES
AND OPPORTUNITIES
Abstract
Smoking remains the leading cause of preventable death worldwide.
Nicotine Replacement Therapies (NRTs) are the most commonly used smoking
cessation medications. However, the scope of these treatments is
limited: drop-out rates are high and their effectiveness is modest. We
believe that nicotine tapering plays an important role in overall
smoking cessation efficacy. However, each of the NRTs currently on the
market have been approved on the basis of either a unique tapering
strategy or none at all. Therefore, it is unknown whether improved
efficacy and safety outcomes could have been achieved by using different
approaches. Moreover, dosing regimens of marketed NRTs lack
personalization. They are based on a “one-size-fits-all” approach,
which is not optimal given that smokers represent a highly heterogeneous
group. The emergence of digital health and Electronic Nicotine Delivery
Systems (ENDS), which have demonstrated superior outcomes compared to
NRTs in terms of smoking cessation rates, give way to the development of
new innovative ways to gradually reduce nicotine in a personalized
fashion, without the limitations of currently approved NRTs.