Essential elements of smoking cessation therapy is that the individual must want to stop smoking and must be willing to work hard to achieve the goal of smoking abstinence. Individual and combined pharmacotherapies in combination with counseling can significantly increase rates of cessation. The first line of treatment include: therapy with an antidepressant (e.g., bupropion) and nicotine replacement therapy (varenicline) Varenicline - a4b2 nicotinic acetylcholine receptor paial agonist S/E: Increase suicidal ideation and must be used with caution. Prolonged use of varenicline beyond the initial induction phase proved useful in maintaining smoking abstinence. For second line of treatment: Clonidine and noriptyline are recommended