Buspirone Reduces Smoking

To the Editor.—  There are no universally accepted treatments of tobacco smoking. We treated with buspirone in an open, uncontrolled six-week trial without psychologic interventions eight smokers who smoked over 1.5 packs of cigarettes per day for over five years. All subjects had attempted to stop smoking, without success. None of the subjects met DSM-III-R criteria for an anxiety disorder. All subjects completing the six-week trial had substantial reductions in smoking.Buspirone was selected because it, like nicotine, is a nonsedative antianxiety agent and so might oppose the characteristic anxiety, irritability, and fatigue of tobacco withdrawal. Buspirone acts after one to three weeks, causes no sedation, and has no abuse liability.¹ Nicotine activates and may chronically affect central dopaminergic systems^2-3 associated with reward and pleasure. Buspirone also augments dopaminergic transmission, but less directly, via selective blockade of inhibitory dopamine autoreceptors.⁴ Thus, both clinical and perhaps neurochemical