Future Treatments for Tobacco Dependence.

Scientific evidence supports that the combination of psychological counseling and pharmacological treatment is the most effective healthcare intervention to help smokers quit. Four types of medications have been shown to be safe and effective: nicotine replacement therapy (NRT), bupropion, varenicline, and cytisinicline. Nevertheless, based on the results of new studies, we can point out several opportunities for development clinical research in this field: (a) finding the most effective doses for cytisinicline, (b) finding the effectiveness and safety of cytisinicline in smokers with chronic disorders, (c) comparing the effectiveness and safety of cytisinicline at higher doses with varenicline at standard doses, (d) investigating the effectiveness and safety of varenicline and cytisinicline used at standard doses but in different pharmaceutical formulations, (e) comparing the effectiveness and safety of cytisinicline at higher doses with nicotine replacement combined treatment, (f) determining the effectiveness and safety of smoking cessation medications as a treatment for new tobacco and nicotine products users (electronic cigarettes and heated tobacco users), (g) to determine the effectiveness and safety of combining pharmacological treatment for smoking cessation with non-invasive brain stimulation, and (h) to optimize the efficacy and safety of smoking cessation medications based on nicotine metabolite ratio (NMR) and probably the most recent suggestion to determine the efficacy and safety of glucagon-like peptide-1 (GLP-1) receptor agonists. All these aspects will be discussed in this paper.