Are differences in guidelines for the treatment of nicotine dependence and non-nicotine dependence justified?
Article first published online: 29 APR 2009
© 2009 The Authors. Journal compilation © 2009 Society for the Study of Addiction
Volume 104, Issue 12, pages 1951–1957, December 2009
How to Cite
Hughes, J. R. and Weiss, R. D. (2009), Are differences in guidelines for the treatment of nicotine dependence and non-nicotine dependence justified?. Addiction, 104: 1951–1957. doi: 10.1111/j.1360-0443.2009.02561.x
- Issue published online: 9 NOV 2009
- Article first published online: 29 APR 2009
- Submitted 23 July 2008; initial review completed 30 October 2008; final version accepted 3 February 2009
- smoking cessation;
- substance-related disorders;
Despite the many similarities between nicotine dependence and other drug dependences, national guidelines for their treatment differ in several respects. The recent national guideline for the treatment of nicotine dependence has (i) less emphasis on detailed assessment; (ii) less emphasis on treatment of psychiatric comorbidity; (iii) less acceptance of reduction of use as an initial treatment goal; (iv) greater emphasis on pharmacological interventions; and (v) less emphasis on psychosocial treatment than national guidelines for non-nicotine dependences. These treatment differences may occur because (i) nicotine does not cause behavioral intoxication; (ii) psychiatric comorbidity is less problematic with nicotine dependence; (iii) psychosocial problems are less severe with nicotine dependence; and (iv) available pharmacotherapies for nicotine dependence are safer, more numerous and more easily available. However, it is unclear whether these treatment differences are, in fact, justifiable because of the scarcity of empirical tests. We suggest several possible empirical tests.