P1.2.4 Other agents

A number of other agents have been shown to be effective in smoking cessation but are not commonly used in clinical practice. Clonidine, an antihypertensive agent, increased smoking cessation 12 weeks following the end of treatment compared to placebo, although abstinence was not objectively confirmed in all studies (NNT = 12, 95% CI 6 to 32). There was a high incidence of dose-dependent adverse effects, particularly dry mouth and sedation (Gourlay 2004). Anxiolytics have not been shown to be effective in smoking cessation. A Cochrane systematic review including one trial each of diazepam, meprobamate, metoprolol and oxprenolol and two trials of buspirone concluded there was no strong evidence of an effect for any of these drugs, but confidence intervals were wide, and an effect of anxiolytics cannot be ruled out on current evidence (Hughes 2000).