A patient with moderate nicotine dependence wishes to quit smoking and has a Fagerström score of 7. What is the best therapeutic option for this patient?

A patient with a Fagerström score of 7 indicates moderate nicotine dependence, which suggests a relatively high level of addiction and a likely need for a more intensive smoking cessation intervention.

The best therapeutic option involves the use of Nicotine Replacement Therapy (NRT), which aims to alleviate withdrawal symptoms and reduce cravings for nicotine. In this case, a 4-mg nicotine lozenge is recommended as it provides a stronger dose suitable for someone with moderate dependence. Utilizing the 4-mg lozenge allows for more flexibility in dosing and provides a quicker delivery of nicotine to manage both cravings and withdrawal symptoms effectively.

Using one lozenge every 1-2 hours for 6 weeks is a well-structured approach to gradually wean the patient off nicotine. The frequent dosing reflects the need to address the high cravings associated with a Fagerström score of 7, as patients with moderate dependence often require more consistent nicotine delivery to remain comfortable during cessation attempts.

Other options like the 2-mg lozenge or the 7-mg patch do not provide sufficient dosage for someone with this level of dependence, possibly leading to inadequate symptom control. The 21-mg patch is a viable option, but the lozenge provides additional flexibility