Craving and treatment in smoking

Min-Hyuk Kim; Seongho Min

doi:10.5124/jkma.2011.54.4.401

J Korean Med Assoc > Volume 54(4); 2011 > Article

Kim and Min: Craving and treatment in smoking

Continuing Education Column

Journal of the Korean Medical Association

Journal of the Korean Medical Association 2011; 54(4): 401-408.

Published online: April 08, 2011

DOI: http://dx.doi.org/10.5124/jkma.2011.54.4.401

Craving and treatment in smoking

Min-Hyuk Kim, MD, Seongho Min, MD

Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, Korea.

Corresponding author: Seongho Min, mchorock@yonsei.kr

Received February 10, 2011 Accepted February 20, 2011

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Craving has been well known to be the most important clinical phenomenon in smoking cessation treatment and one that physicians always encounter. For successful and prolonged abstinence, understanding, evaluation, and management of craving are essential. The concept and definition of craving is still under debate, although its importance, relevance, and role in smoking relapse is evident. There are two types of craving, 'abstinence-induced craving' and 'cue-induced craving' according to time dynamic and causes. The evaluation of craving mainly depends on self-reported measures in the clinical field. Pharmacological treatments such as the nicotine patch, bupropion, and varenicline are effective for abstinence-induced craving. Psychosocial treatment and a few pharmacological agents such as nicotine gum and lozenges are useful for reducing cue-induced craving. This review was aimed at conveying up-to-date information on the characteristics, evaluation, and treatment of craving. Development of objective measurement tool for evaluation of craving is needed. The effects of pharmacological treatments on 'cue-induced craving' remain to be discovered. An active effort to alleviate each type of craving is necessary to enhance and prolong a patient's abstinence.

Smoking; Tobacco use disorder; Craving; Urge

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Table 1

Advantage and disadvantage of available drugs for smoking cessation in Korea