American Board of Internal Medicine (ABIM) Certification Practice Exam

Which medication has been found to be more effective than bupropion for smoking cessation?

1. Nicotine gum

2. Varenicline

3. Nicotine patch

4. Chantix

The correct answer is: Varenicline

Varenicline has been shown to be more effective than bupropion for smoking cessation, making it a highly regarded option in tobacco dependence treatment. Varenicline works by stimulating nicotine receptors in the brain, which leads to the release of dopamine, mitigating withdrawal symptoms and cravings. This dual mechanism helps not only to ease the transition away from nicotine but also to reduce the pleasurable effects of smoking if a person does relapse, ultimately supporting sustained cessation. In clinical studies, varenicline has consistently demonstrated higher quit rates compared to bupropion. This evidence highlights its efficacy and aligns with guidelines that often prioritize varenicline as a first-line medication for smoking cessation due to its effectiveness and favorable side effect profile. While other options like nicotine gum or patches are also effective for some individuals, they primarily replace nicotine and do not significantly alter the reward pathway in the same way varenicline does. As for Chantix, it is actually the brand name for varenicline, so discussing it separately does not change the fact that varenicline is the effective agent in this context.