• M R Nichols.
• Lee's Hill Medical Associates, Fredericksburg, Virginia, USA. mrnichol@hsc.vcu.edu
• Clin Excell Nurse Pract. 1999 Nov 1; 3 (6): 317-22.

AbstractAll healthcare providers have an obligation to promote smoking cessation to their patients who smoke. While patients are advised to stop smoking, the use of specific smoking cessation strategies is rarely addressed by primary care providers. This article discusses smoking cessation for two specifically vulnerable groups: women and African-Americans. Both groups have been identified as having increased rates of nicotine metabolism and may be less likely to respond effectively to nicotine replacement for smoking cessation. Increased nicotine metabolism results in greatest difficulty with successful smoking cessation and creates an increased vulnerability to a wide range of cardiovascular and respiratory health problems associated with smoking. Nicotine replacement therapy for smoking cessation has been the most common treatment available; however, many patients have not been successful with that method, and a majority (75%) of smokers who attempt to stop smoking return to smoking. The use of bupropion hydrochloride (Zyban) as a nonnicotine replacement therapy for smoking cessation is discussed. Relapses in smoking cessation are due to nicotine craving and the attempt to alleviate symptoms of nicotine withdrawal. Bupropion hydrochloride, an oral antidepressant, is believed to work by elimination of nicotine cravings and to decrease the physiologic and psychologic symptoms associated with nicotine withdrawal. Patients who have not been successful in smoking cessation may benefit from bupropion hydrochloride therapy in conjunction with counseling and behavior modification.

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