Which pharmacotherapy option is NOT recommended for a patient with a significant history of skin irritation from patches?

The choice of pharmacotherapy for a patient with a significant history of skin irritation from patches must consider the potential for adverse reactions. Bupropion SR® is an oral medication that does not involve any transdermal application, thus eliminating the risk of skin irritation that can occur with patch-based therapies.

In contrast, other options might not be suitable in this specific scenario due to the risk of skin irritation associated with patches. Varenicline® is a non-nicotine medication that targets nicotine addiction but requires a careful evaluation of the patient's previous adverse reactions. Ad lib NRT with gum or lozenge offers flexibility in nicotine replacement therapy without a patch, but it may still present challenges if the patient has a broader sensitivity to nicotine products. Behavioral therapy, while beneficial, does not provide the pharmacological assistance that some patients may need during their quit attempt.

Focusing on the need to avoid exacerbating skin irritations, Bupropion SR® stands out as a safe choice for patients with such histories, affirming its recommendation over the other options that may provoke similar previous reactions.