SMOKING

  • Tobacco use is a risk factor in diseases such as cancer, coronary heart disease, stroke and COPD.1
  • ~1.3B smoke worldwide, or ~33% of the adult population. ~ 6M die from tobacco-related diseases. This number is expected to reach 8M worldwide by 2030.2
  • In the US, 16.8% of adults smoke.3 This number has declined from 20.9% in 2005, and it continues to drop.4
  • Quitting smoking is difficult - nicotine withdrawal causes anxiety, irritability, and having trouble thinking.5
  • 68.6% of U.S. smokers reported in 2010 that they wanted to quit completely.6 42.8% quit for at least one day.6
  • Of those who do quit, 80% will resume smoking by 6 months.7

Treatments and Market

Broadly, there are two types of FDA-approved treatments for smoking cessation:

  • Nicotine Replacement Therapy (NRT). NRT substitute controlled nicotine doses for smoking tobacco.
    • NRTs increase the chances of quitting by 50-70%, but 93% relapse in 6 months.8
    • Medications include transdermal patches (NicoDerm; GSK), gums (Nicorette; GSK), lozenges (Commit; GSK), inhalers (Nicotrol; Pfizer) and nasal sprays (Nicotrol NS; Pfizer).
  • Non-Nicotine Products (NNP). There are now two medicines on the market that do not contain nicotine:
    • NNPs increase the chances of quitting 3-fold over those who didn’t use medication.9
      • Chantix/Champix (Varenicline) from Pfizer. It is a partial agonist of the alpha4/beta2 nAChR.
      • Zyban (Bupropion) from GSK. Brupropion has a broad MOA – it is weak inhibitor of dopamine and noradrenaline reuptake, antagonizes nAChR function, and affects serotonin.1 It is also used to treat depression, ADHD, bipolar disorder, and promote weight loss.10,11
  • The overall market for smoking cessation treatments is strongly growing – from $1.9B in 2011 to a projected $3.8B in 2016. (100% increase). The largest percentage gains were from NRTs.

The Market for FDA-Approved Smoking Cessation Products (2011-16)

A projected doubling of market size, with the NRTs making % gains.
Data from from Syed et al., 2013

Selected Treatments in Clinical Development for Smoking Cessation

  • In 2013, the biopharmaceutical industry, academic institutions and NIH had a total 15 smoking cessation treatments in clinical trials. Only one was an NRT.

Figure from Syed et al., 2013

ClinicalTrialSmokingCessation.png

Companies

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