Smokers With Comorbid Medical Problems

General precautions for each medication that has been used for smoking cessation are listed in the sections describing each medication. All FDA-approved first-line medications for smoking cessation have a relatively good safety profile. Consensus opinions on the safety of the various medications for persons with cardiovascular disease, other medical conditions, and pregnancy are beyond the scope of this chapter but can be found elsewhere (Society for Research on Nicotine and Tobacco 2003). 

In general, for smokers with cardiac disease, the benefits of nicotine replacement therapy outweigh the potential risks. In a safety and efficacy study that included veterans with cardiac disease, smoking concurrently with the nicotine patch was not associated with an increase in adverse events (Joseph et al. 1996). Although bupropion SR is generally well tolerated by smokers, it has not been adequately studied in persons with cardiac disease, and definitive conclusions regarding its safety in this patient population cannot currently be made (Society for Research on Nicotine and Tobacco 2003). 

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