ANTIGONA TROFOR*, MILENA ADINA MAN**,DANA ALEXANDRESCU***, RAMONA MIRON**** *University of Medicine and Pharmacy “Gr. T. Popa” Iasi, Romania **University of Medicine and Pharmacy “Iuliu Hatieganu” Cluj, Romania *** University of Medicine, Brasov, Romania ****Clinic of Pulmonary Diseases, Iasi, Romania 30, Dr. Iosif Cihac Street, 700115, Iasi ROMANIA atrofor@yahoo.com Varenicline is a first line smoking cessation pharmacotherapy. Smokers with comorbidities are prevalent in our center. The aim of the study was to assess efficacy and safety of varenicline in current practice of a smoking cessation center treating smokers with high prevalence of concomitant disorders. 98 smokers with concurrent stable respiratory, cardiovascular, digestive and psychiatric disorders (study group) and 116 healthy smokers (control group) were treated with varenicline in a 12 weeks cure to quit smoking. Primary end point was carbon monoxide confirmed continuous abstinence rate in the study group at weeks 9@ 12. Secondly, varenicline safety, discontinuation profile and compliance to treatment were monitored. 41.8% smokers with comorbidities (25/52cardiovascular, 9/26 respiratory, 4/13 digestive, 3/7 psychiatric) and 40.5% healthy smokers successfully quit smoking. Withdrawal symptoms and adverse effects picture did not differ significantly between groups. Varenicline is an effective and highly compliant therapy for smoking cessation in smokers with comorbidities. Safety profile of varenicline is comparable in healthy smokers and smokers with stable comorbidities. smoking cessation, Varenicline, comorbidities, nicotine dependence, safety, compliance Smoking is a major cause of premature morbi@mortality in the world. Moreover, tobacco use is recognized as the most important avoidable such risk factor, as life expectancy of smokers is. in average, with 5 @ 8 years shorter than in never smokers, even if smoking related diseases do not intervene. Nearly one of every 5 deaths in the U.S.A. is due to cigarette smoking. [1] Despite continuous tobacco control measures implemented in the last decades, tobacco consumption is still a current practice for about one third of globe’s population. Nowadays, 12% of women and 42% of men worldwide use tobacco [1]. Three out of 10 EU citizens aged 15 and over say they smoke: a quarter (26%) smoke daily and 5% occasionally. Most daily smokers are men, 25@54 year@olds and manual workers [2]. The percentage of smokers is the highest in Greece (42%), followed by Bulgaria (39%), Latvia (37%), Romania, Hungary, Lithuania, the Czech Republic and Slovakia (all 36%). [3] Tobacco exposure influences almost every organ in the human body of active smokers and it has also negative effects over pregnancy and delivery in smoking women, as well as in passively tobacco smoke exposed individuals. All this happens because cigarette smoke contains 4800 identified chemical compounds, among which 250 cause cancer or are toxic in other ways [1]. It is estimated that 61 chemicals in tobacco smoke cause cancer, with polycyclic aromatic hydrocarbons, nitrosamines, and aromatic amines being major contributors. Carbon monoxide and other chemicals in tobacco smoke contribute to processes leading to cardiovascular disease, such as endothelial injury and dysfunction, atherosclerosis, platelet aggregation, thrombosis, low@grade inflammation, and increased levels of carboxyhemoglobin. Active smoking induces processes of oxidative stress, inflammation and protease–antiprotease imbalances that injure airways and alveoli and if sustained, conduct to chronic obstructive pulmonary disease. As a consequence, chronic tobacco consumption is a main cause for many diseases, if we refer here just to cancers, chronic obstructive pulmonary disease (COPD), cardio@ vascular diseases, sudden death, cataract, Recent Researches in Modern Medicine ISBN: 978-960-474-278-3 261