There are a variety of medications to help you stop smoking. Some contain nicotine and some are nicotine-free. These include nicotine replacement products (such as gum and patches) and medications such as Bupropion and Varenicline.
It is also important to get support from others, either in 12-step or other peer-based recovery program, an app, or online support.
What they do:
Nicotine Replacement Therapy (NRT) gradually provides your body with smaller doses of nicotine, without the toxic chemicals in cigarette smoke. This helps relieve the withdrawal symptoms and cravings that can often lead to relapse. Many people use NRT in the early stages of quitting. If you have a severe addiction to nicotine you can use NRT for a longer time.
Bupropion and Varenicline
Bupropion (immediate-release and extended-release) was originally approved as an antidepressant. It stimulates the release of dopamine, the brain's natural pleasure chemical, and blocks nicotine receptors.
Varenicline is a smoking-cessation aid that helps reduce nicotine cravings by stimulating nicotine receptors in the brain but less strongly than nicotine.
Do they work?
Studies show that bupropion can increase quit rates and is as effective as NRT. Varenicline also boosts the odds of successfully quitting – and some studies find it is more effective than NRT or bupropion alone.
Combining medications has shown success. A combination of varenicline and NRT, especially using a nicotine patch before quitting, may work better than varenicline alone.
Adding bupropion to NRT also improves quit rates. For smokers who aren’t able to cut down significantly by using the NRT patch, combining extended-release bupropion and varenicline can be effective, especially in men who are very dependent on nicotine.
NICOTINE REPLACEMENT PRODUCTS
What they do: provide smaller doses of nicotine without smoking and without the dangerous chemicals in cigarettes
How they work: They help lessen the body's craving for nicotine and reduce withdrawal symptoms. They come in several forms: gum, patch, nasal spray, inhaler, lozenge and e-cigarettes.
- Gum (dizziness, headache, nausea)
- Nasal spray (runny nose, throat irritation, coughing, sneezing, watery eyes)
- Patch (dizziness, headache, nausea, vomiting, diarrhea)
- Inhaler (mouth and throat irritation, runny nose, sinus pressure, headache, gas)
- Lozenge (heartburn, sore throat, mouth problems, irregular or fast heart beat)
For a more complete list of side effects, visit this NIH page and scroll down to Nicotine.
Click here for more information on nicotine replacement products
Availability: Nicotine gum, patch, lozenges and e-cigarettes (vaping) can be bought at most local drug stores.
Using e-cigarettes (vaping) to stop smoking
Some people use e-cigarettes to stop smoking. But vaping is also bad for your health. Regular cigarettes have about 7,000 chemicals, many that are toxic. E-cigarettes don’t have as many chemicals, but they do have heavy metals and toxic chemicals – which means you are exposing yourself to all kinds of chemicals that are unhealthy and not safe.
According to the CDC, vaping is linked to much higher risks of heart attack, coronary artery disease, lung diseases, strokes and death.
Overall, vaping is not the best tool to quit smoking. It is linked to high risks for heart attack, coronary artery disease, lung diseases, strokes and death. And while they help some people quit, they also increase the risk of relapse in former smokers.
Health alert about vaping
The growing number of cases of severe lung disease and death in people who use e-cigarettes highlights their danger. Experts believe this is most likely due to a toxin in the inhaled vapors.
Teenagers and young adults who vape also face a much higher risk of COVID-19. A Stanford University study found that they were five to seven times more likely to be infected than those who did not vape.
Click here for more information on e-cigarettes.
Availability: Nicotine gum, patch, lozenges and E-cigarettes (vaping) can be bought at most local drug stores.
A 2018 review of nicotine replacement products showed they can increase the chances of success by 50% to 60%. Hartmann-Boyce J 2018.
BUPROPION (brand names Zyban and Wellbutrin)
What it does: This antidepressant medication can also be used to help some people quit smoking.
How it works: Although it does not contain nicotine, it can help you resist the urge to smoke. It is often started 1 or 2 weeks before you stop smoking and can be used for up to 6 months to prevent relapse.
Side effects: Insomnia, dry mouth, dizziness, headache, nausea, constipation. Serious side effects include seizures and thinking about or planning suicide.
For a more complete list of side effects, visit this NIH page.
Availability: By prescription from a physician
Treatment with bupropion lessens cravings by reducing activity in certain areas of the brain. Culbertson CS 2011.
Bupropion was effective for nicotine cessation in a number of studies, helping about one in five smokers quit. Up to half of those taking it experience side effects, mainly insomnia and a dry mouth, which are closely linked to the nicotine withdrawal syndrome. Wilkes S 2008.
In this large review of studies, bupropion increased rates of long-term smoking cessation in 45 studies of 17,866 people. But it also caused more serious side effects that may have led people to stop taking it. These included depression, anxiety, panic attacks, restlessness, anger and suicidal thoughts. Howes S 2020.
What it does: Varenicline is considered a smoking cessation aid. It blocks the pleasant effects of nicotine and reduces nicotine withdrawal symptoms and cravings. This helps prevent relapse by blocking the effects of nicotine if you begin to smoke again.
How it works: Studies show that the drug stimulates dopamine (the brain's natural pleasure chemical) and blocks nicotine receptors.
Side effects: Nausea, vomiting, gas, heartburn, vomiting, headache.
For a more complete list of side effects, visit this NIH page.
Availability: Physician prescription
Note: As of June 2021 Chantix is no longer on the market but the generic version (varenicline) is still available.
In two studies, Chantix helped more people quit than bupropion (Zyban), the only other nicotine-free medication used as a quit-smoking aid. Foulds 2006.
A combination of Chantix and bupropion proved much better than Chantix alone in helping male smokers who had not been able to stop smoking by using the nicotine patch. Rose JE 2017.
In this review of 8 studies, using varenicline to quit smoking reduced depression, anxiety, restlessness and irritability in smokers who do not have current psychiatric disorders. It did increase sleep problems and appetite. Foulds J 2013.
Warning: Some people have had changes in behavior, mood and thoughts of suicide while taking Chantix. Its role in causing these changes is not clear. In 2016 the FDA stated that the risk of these serious side effects is lower than they thought. But the risk is still there, especially in those being treated for depression, anxiety disorders, or schizophrenia.
In 2016 the FDA stated that the risk of these serious side effects is lower than they thought. But the risk is still present, especially in those being treated for depression, anxiety disorders, or schizophrenia.
If you have any of the following symptoms, stop taking Chantix and call your doctor right away: thoughts of killing yourself; new or worsening depression, anxiety, or panic attacks; restlessness; angry or violent behavior; excited mood (mania); hallucinations; feeling that people are against you; feeling confused; or any other sudden or unusual changes in behavior, thinking, or mood.
You should also contact your health care professional if you have new or worsening symptoms of heart disease, such as chest pain, shortness of breath, calf pain when walking, or sudden weakness, numbness, or difficulty speaking.
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