Pharmacology · Class
Smoking cessation medicines !
Medicines that ease craving and withdrawal when quitting tobacco: nicotine replacement, varenicline, cytisine and bupropion. They work best with support.
Updated 2026-11-01
What they are
WHO's 2024 guideline names varenicline, nicotine replacement therapy, bupropion and cytisine as effective treatments for quitting tobacco, combined with behavioural support. More than 60% of the world's tobacco users want to quit.
Mechanism of action
Nicotine replacement gives nicotine without smoke, at steadier levels, to soften withdrawal. Varenicline and cytisine are partial agonists at α4β2 nicotinic receptors: they partly stimulate them, easing craving, and block nicotine from binding, so smoking gives less reward.
Target: α4β2 nicotinic acetylcholine receptor
Drugs in this class
- VareniclineA nicotinic receptor partial agonist that eases craving and makes smoking less rewarding. Nausea and vivid dreams are…Nicotinic acetylcholine receptor α4β2
- Nicotine (replacement therapy)Nicotine without the smoke, as patches, gum, lozenges or sprays, to ease craving and withdrawal while quitting tobacco.Nicotinic acetylcholine receptor α4β2
- CytisineA plant alkaloid that is a nicotinic partial agonist, used to quit smoking. WHO added it to the essential medicines…Nicotinic acetylcholine receptor α4β2
Others in the class
- Bupropion
Test yourself
Think of the answer, then tap the question to see it.
Which four medicines does WHO name for quitting tobacco?
Varenicline, nicotine replacement therapy, bupropion and cytisine.
What are the two effects of a nicotinic partial agonist in smoking cessation?
It eases craving by partial stimulation and reduces the reward of smoking by blocking nicotine.
Why may theophylline or warfarin need review when someone quits smoking?
Quitting smoking itself can change how these drugs act.
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: WHO releases first-ever clinical treatment guideline for tobacco cessation in adults (World Health Organization, 2024); DailyMed - VARENICLINE tablet, film coated VARENICLINE kit (DailyMed (U.S. National Library of Medicine), 2026); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 13 (McGraw Hill, 2023); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
Spotted a mistake?We are always improving for the community. Tell us what is wrong and our team will review it.Report a mistake
Representative model, for educational purposes only.