The War against Nicotine and Tobacco: New Tools?

given the favorable clinical response of patients with major depression treated with serotonin reuptake inhibitors. The majority of smokers want to stop smoking completely; however, the estimated rate of successful quitting is only 2.5% of all smokers per year. The rate of ‘self-quitters’ for continuous abstinence one year after their cessation attempt is only 4.3%. The nicotine withdrawal syndrome is well-known and includes symptoms of increased anxiety, irritability, and appetite as well as decreased cognitive capabilities and heart rate. Withdrawal symptoms peak within a few days and then begin to recede over the next several weeks. However, most individuals who try to quit smoking relapse before the syndrome subsides. Nicotine replacement does not appear to shorten the course of the syndrome, but it can reduce severity of the symptoms to the more tolerable levels typically observed after about 4–5 weeks of untreated abstinence. Some withdrawal symptoms, particularly cognitive impairment, cravings, and irritability, may persist for months. Therefore, there is an urgent need for innovative and effective tools to help smokers quit. Two articles in this issue of ONKOLOGIE deal in very different but complementary ways with the problem of smoking cessation. The review by Cornuz [1] addresses counseling and accompanying the smoker through the difficult phase of cessation and staying tobaccofree as a well established but often neglected strategy. A new method to overcome the nicotine addiction is vaccinating smokers against nicotine in order to prevent the nicotine molecule to enter the CNS in sufficient amounts. This new promising approach has just entered phase 1 in some centers in Europe and the US, and results of the preclinical work are summarized in the original article by E.H. Cerny et al. [2]. T. Cerny, St. Gallen