You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Getting counseling, along with using medicine, can increase your
chances of quitting even more.
If you smoke fewer than 10
cigarettes a day, you may not need medicines to help you quit smoking.
It's rare for someone to get addicted to nicotine medicines,
because the nicotine is released slowly into your bloodstream.
The
side effects of nicotine replacement products depend on the type of product.
For example, a patch can make your skin red and itchy. Medicines in pill form
can cause nausea, dry mouth, and trouble sleeping. For most people, the side
effects aren't bad enough to make them stop using the medicines.
Nicotine medicines have less nicotine than cigarettes. And by
itself, nicotine is not nearly as harmful as smoking. The tars, carbon
monoxide, and other toxic chemicals in tobacco cause the harmful effects.
Many insurance companies will pay for all or part of the cost of
medicines used to quit smoking.
Your doctor may prescribe
varenicline (Chantix) or bupropion (Zyban) to help you cope with cravings for
tobacco. These medicines are pills that don't contain nicotine. You also can
use nicotine replacement products, which do contain nicotine.
Medicines that don't have nicotine
Varenicline (Chantix) blocks the effects of nicotine and reduces cravings and
withdrawal symptoms. If you start smoking again while
you are taking the medicine, you won't feel as satisfied. This improves your
chances of quitting. You start taking the medicine about a week before you quit
smoking, and you take it for 12 to 24 weeks. You take it 2 times a day, after
meals.
Bupropion SR (Zyban) can help
balance chemicals in your brain to reduce your withdrawal symptoms. Doctors
also prescribe this medicine (under the brand name Wellbutrin) to treat
depression. But it can help you stop smoking even if
you don't have depression. You start taking bupropion daily about 1 to 2 weeks
before you quit smoking. This builds up the level of medicine in your body. You
keep taking it for 7 to 12 weeks after you stop smoking.
Nicotine replacement gives your body
some nicotine to help reduce withdrawal symptoms and cravings. Nicotine is
addictive. But this treatment has about one-third to one-half the amount of
nicotine in most cigarettes. It also delivers the nicotine slowly, so it's not
as addicting as the nicotine in cigarettes. And these products don't have the
harmful tars, carbon monoxide, and other toxic chemicals that are in tobacco.
There are several types of nicotine replacement:
Gum and
lozenges slowly release nicotine into your
mouth.
Patches stick to your skin and slowly
release nicotine into your bloodstream.
An inhaler has a holder that contains nicotine. It delivers a
puff of nicotine vapor into your mouth and throat.
Nicotine nasal spray (Nicotrol) is another nicotine replacement. It is not widely used. See your doctor about this medicine.
You can buy nicotine gum, patches, and lozenges without a
prescription. You need a prescription to buy inhalers. You may be able to use a
couple of these products at the same time, such as a patch and gum. But talk to
your doctor first to make sure it's okay to mix nicotine medicines. People
younger than age 18 can't buy the
over-the-counter products, but a doctor may prescribe
them.
Talk to your doctor if you're pregnant or planning to
become pregnant and want to stop smoking. Most doctors will recommend that you
try other ways to stop smoking before using nicotine replacement.
Be sure to talk your doctor before using these products if you have a
health condition, such as mental illness or heart problems.
Some studies have found that
varenicline (Chantix) works better than
bupropion SR (Zyban).2 But
every person is different. So one medicine may work better for you than the
other.
Some people also have side effects such as nausea,
headaches, and dizziness.
Varenicline may cause some mental
illness symptoms, such as
depression. If you have a mental illness, be sure to talk to your doctor before using
these products.
There is a small risk of having
seizures when you use bupropion. The risk increases if
you have had a head injury or seizures.
Tell your doctor about
all the medicines you take. When you stop smoking, there may be a change in how
other medicines work for you.
FDA Warning. The U.S. Food and
Drug Administration (FDA) warns that people who are taking bupropion (Zyban) or varenicline (Chantix) and who experience any serious or unusual changes in mood or behavior or who feel like hurting themselves or someone else should stop taking the medicine and call a doctor right away.
Friends or family members who notice these changes in behavior in someone who is taking bupropion (Zyban) or varenicline (Chantix) for smoking cessation should tell the person their concerns and advise him or her to stop taking the drug and call a doctor right away.
Nicotine patches can
cause itching and redness where you put the patch. If you use a 24-hour patch,
you may have trouble sleeping or have very vivid dreams. This is because your
brain isn't used to getting nicotine when you're sleeping. Taking off the patch
after 8 p.m. may help ease your sleep problems.
Nicotine gum can cause an upset stomach (nausea) or heartburn.
Gum is not a good choice for people who have dentures or problems with their
jaw joint (TM disorders).
Nicotine lozenges can cause an upset stomach, hiccups, heartburn, headaches, and
gas.
Nicotine inhalers can cause a cough, a
scratchy throat, and an upset stomach. An inhaler may not be a good choice if
you have
asthma, allergies, or a sinus problem.
Personal stories from people who have quit smoking
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
I started
smoking when I was in the military. But it is affecting my health, and I want
to quit. I've tried the patch, gum, and cold-turkey methods to quit, and they
didn't work. So I talked with my doctor about quitting, and he suggested that I
try using Chantix. He also recommended that I have counseling and join a
support group. It's been a little over a month since I started Chantix, and so
far it is helping with my craving to smoke. Talking in counseling is also
helpful. I think I finally am going to be able to quit.
Dave, age 42
I thought about taking medicine to quit
smoking, but I already take several other medicines for health problems. I just
didn't want to take another prescription medicine and take the chance that it
might cause problems. So I decided to try the nicotine patch. I set a date and
started planning for the physical effects of quitting, like having munchies
around and cleaning my car and house. I started with the largest patch
available. It was great because the withdrawal symptoms were hardly noticeable.
Then I went to the medium patch and finally the smallest patch. Now I don't
smoke anymore.
Alanna,
age 44
I started smoking at 15. I always thought I could quit at any time
and had tried to quit dozens of times. But then I'd start craving a smoke, and
I'd go back to cigarettes. A few years ago, my doctor suggested I try taking
Zyban and nicotine gum. It was great, because
between the pills and the gum, the withdrawal symptoms
were hardly noticeable. I was done with the gum after the first few
weeks, but I ended up staying on the pills for 6 months. But using both worked
for me, and I haven't smoked for 2 years.
Carlo, age 52
My friends
pushed me to quit smoking and suggested I talk to my doctor about getting some
medicine to help. But I just wasn't comfortable with the idea of taking
medicine. I have a strong will, and when I put my mind to doing something, I
can usually do it. So I took my doctor's advice to have professional counseling
to help improve my chances of success. I quit smoking—cold turkey—5 months ago.
All my friends are really surprised that I could quit like that. It has been
tough at times fighting the cravings, but it has worked.
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to use medicine to quit smoking
Reasons not to use medicine
I want to use medicine if it can increase my chances of quitting.
I don't like using medicine.
More important
Equally important
More important
I'm not concerned about possible side effects.
I am very concerned about side effects.
More important
Equally important
More important
I'm not worried about how I will pay for the medicine.
I'm worried about how I will pay for the medicine.
More important
Equally important
More important
My other important reasons:
My other important reasons:
More important
Equally important
More important
Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Using medicine
NOT using medicine
Leaning toward
Undecided
Leaning toward
What else do you need to make your decision?
Check the facts
1.
Using medicine can double my chances of quitting smoking.
TrueYou're right. Using medicine can double your chances of quitting smoking. It can relieve nicotine withdrawal symptoms.
FalseSorry, that's not right. Using medicine can double your chances of quitting smoking. It can relieve nicotine withdrawal symptoms.
I'm not sureIt may help to go back and read "How well do medicines work?" Using medicine can double your chances of quitting smoking. It can relieve nicotine withdrawal symptoms.
2.
My chances of quitting are even better if I get counseling along with using medicine.
TrueThat's right. Counseling and medicine together can increase your chances of quitting even more.
FalseNo, that's not right. Counseling and medicine together can increase your chances of quitting even more.
I'm not sureIt may help to go back and read "How well do medicines work?" Counseling and medicine together can increase your chances of quitting even more.
3.
I shouldn't use nicotine replacement products, because they're just as bad as the nicotine in cigarettes.
TrueThat's not right. Nicotine is addictive. But by itself, it's not nearly as harmful as smoking. Tars, carbon monoxide, and other toxic chemicals in tobacco cause the harmful effects.
FalseYou're right. Nicotine is addictive. But by itself, it's not nearly as harmful as smoking. Tars, carbon monoxide, and other toxic chemicals in tobacco cause the harmful effects.
I'm not sureIt may help to go back and read "What are the medicines?" Nicotine is addictive. But by itself, it's not nearly as harmful as smoking. Tars, carbon monoxide, and other toxic chemicals in tobacco cause the harmful effects.
Decide what's next
1.
Do you understand the options available to you?
2.
Are you clear about which benefits and side effects matter most to you?
3.
Do you have enough support and advice from others to make a choice?
Certainty
1.
How sure do you feel right now about your decision?
Not sure at all
Somewhat sure
Very sure
2.
Check what you need to do before you make this decision.
Getting counseling, along with using medicine, can increase your
chances of quitting even more.
If you smoke fewer than 10
cigarettes a day, you may not need medicines to help you quit smoking.
It's rare for someone to get addicted to nicotine medicines,
because the nicotine is released slowly into your bloodstream.
The
side effects of nicotine replacement products depend on the type of product.
For example, a patch can make your skin red and itchy. Medicines in pill form
can cause nausea, dry mouth, and trouble sleeping. For most people, the side
effects aren't bad enough to make them stop using the medicines.
Nicotine medicines have less nicotine than cigarettes. And by
itself, nicotine is not nearly as harmful as smoking. The tars, carbon
monoxide, and other toxic chemicals in tobacco cause the harmful effects.
Many insurance companies will pay for all or part of the cost of
medicines used to quit smoking.
Your doctor may prescribe
varenicline (Chantix) or bupropion (Zyban) to help you cope with cravings for
tobacco. These medicines are pills that don't contain nicotine. You also can
use nicotine replacement products, which do contain nicotine.
Medicines that don't have nicotine
Varenicline (Chantix) blocks the effects of nicotine and reduces cravings and
withdrawal symptoms. If you start smoking again while
you are taking the medicine, you won't feel as satisfied. This improves your
chances of quitting. You start taking the medicine about a week before you quit
smoking, and you take it for 12 to 24 weeks. You take it 2 times a day, after
meals.
Bupropion SR (Zyban) can help
balance chemicals in your brain to reduce your withdrawal symptoms. Doctors
also prescribe this medicine (under the brand name Wellbutrin) to treat
depression. But it can help you stop smoking even if
you don't have depression. You start taking bupropion daily about 1 to 2 weeks
before you quit smoking. This builds up the level of medicine in your body. You
keep taking it for 7 to 12 weeks after you stop smoking.
Nicotine replacement gives your body
some nicotine to help reduce withdrawal symptoms and cravings. Nicotine is
addictive. But this treatment has about one-third to one-half the amount of
nicotine in most cigarettes. It also delivers the nicotine slowly, so it's not
as addicting as the nicotine in cigarettes. And these products don't have the
harmful tars, carbon monoxide, and other toxic chemicals that are in tobacco.
There are several types of nicotine replacement:
Gum and
lozenges slowly release nicotine into your
mouth.
Patches stick to your skin and slowly
release nicotine into your bloodstream.
An inhaler has a holder that contains nicotine. It delivers a
puff of nicotine vapor into your mouth and throat.
Nicotine nasal spray (Nicotrol) is another nicotine replacement. It is not widely used. See your doctor about this medicine.
You can buy nicotine gum, patches, and lozenges without a
prescription. You need a prescription to buy inhalers. You may be able to use a
couple of these products at the same time, such as a patch and gum. But talk to
your doctor first to make sure it's okay to mix nicotine medicines. People
younger than age 18 can't buy the
over-the-counter products, but a doctor may prescribe
them.
Talk to your doctor if you're pregnant or planning to
become pregnant and want to stop smoking. Most doctors will recommend that you
try other ways to stop smoking before using nicotine replacement.
Be sure to talk your doctor before using these products if you have a
health condition, such as mental illness or heart problems.
Some studies have found that
varenicline (Chantix) works better than
bupropion SR (Zyban).2 But
every person is different. So one medicine may work better for you than the
other.
Some people also have side effects such as nausea,
headaches, and dizziness.
Varenicline may cause some mental
illness symptoms, such as
depression. If you have a mental illness, be sure to talk to your doctor before using
these products.
There is a small risk of having
seizures when you use bupropion. The risk increases if
you have had a head injury or seizures.
Tell your doctor about
all the medicines you take. When you stop smoking, there may be a change in how
other medicines work for you.
FDA Warning. The U.S. Food and
Drug Administration (FDA) warns that people who are taking bupropion (Zyban) or varenicline (Chantix) and who experience any serious or unusual changes in mood or behavior or who feel like hurting themselves or someone else should stop taking the medicine and call a doctor right away.
Friends or family members who notice these changes in behavior in someone who is taking bupropion (Zyban) or varenicline (Chantix) for smoking cessation should tell the person their concerns and advise him or her to stop taking the drug and call a doctor right away.
Nicotine patches can
cause itching and redness where you put the patch. If you use a 24-hour patch,
you may have trouble sleeping or have very vivid dreams. This is because your
brain isn't used to getting nicotine when you're sleeping. Taking off the patch
after 8 p.m. may help ease your sleep problems.
Nicotine gum can cause an upset stomach (nausea) or heartburn.
Gum is not a good choice for people who have dentures or problems with their
jaw joint (TM disorders).
Nicotine lozenges can cause an upset stomach, hiccups, heartburn, headaches, and
gas.
Nicotine inhalers can cause a cough, a
scratchy throat, and an upset stomach. An inhaler may not be a good choice if
you have
asthma, allergies, or a sinus problem.
Personal stories from people who have quit smoking
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"I started
smoking when I was in the military. But it is affecting my health, and I want
to quit. I've tried the patch, gum, and cold-turkey methods to quit, and they
didn't work. So I talked with my doctor about quitting, and he suggested that I
try using Chantix. He also recommended that I have counseling and join a
support group. It's been a little over a month since I started Chantix, and so
far it is helping with my craving to smoke. Talking in counseling is also
helpful. I think I finally am going to be able to quit. "
— Dave, age 42
"I thought about taking medicine to quit
smoking, but I already take several other medicines for health problems. I just
didn't want to take another prescription medicine and take the chance that it
might cause problems. So I decided to try the nicotine patch. I set a date and
started planning for the physical effects of quitting, like having munchies
around and cleaning my car and house. I started with the largest patch
available. It was great because the withdrawal symptoms were hardly noticeable.
Then I went to the medium patch and finally the smallest patch. Now I don't
smoke anymore. "
— Alanna,
age 44
" I started smoking at 15. I always thought I could quit at any time
and had tried to quit dozens of times. But then I'd start craving a smoke, and
I'd go back to cigarettes. A few years ago, my doctor suggested I try taking
Zyban and nicotine gum. It was great, because
between the pills and the gum, the withdrawal symptoms
were hardly noticeable. I was done with the gum after the first few
weeks, but I ended up staying on the pills for 6 months. But using both worked
for me, and I haven't smoked for 2 years. "
— Carlo, age 52
"My friends
pushed me to quit smoking and suggested I talk to my doctor about getting some
medicine to help. But I just wasn't comfortable with the idea of taking
medicine. I have a strong will, and when I put my mind to doing something, I
can usually do it. So I took my doctor's advice to have professional counseling
to help improve my chances of success. I quit smoking—cold turkey—5 months ago.
All my friends are really surprised that I could quit like that. It has been
tough at times fighting the cravings, but it has worked. "
— Kesia, age
35
3. Your Feelings
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to use medicine to quit smoking
Reasons not to use medicine
I want to use medicine if it can increase my chances of quitting.
I don't like using medicine.
More important
Equally important
More important
I'm not concerned about possible side effects.
I am very concerned about side effects.
More important
Equally important
More important
I'm not worried about how I will pay for the medicine.
I'm worried about how I will pay for the medicine.
More important
Equally important
More important
My other important reasons:
My other important reasons:
More important
Equally important
More important
4. Your Decision
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Using medicine
NOT using medicine
Leaning toward
Undecided
Leaning toward
5. Quiz Yourself
Check the facts
1.
Using medicine can double my chances of quitting smoking.
True
False
I'm not sure
You're right. Using medicine can double your chances of quitting smoking. It can relieve nicotine withdrawal symptoms.
2.
My chances of quitting are even better if I get counseling along with using medicine.
True
False
I'm not sure
That's right. Counseling and medicine together can increase your chances of quitting even more.
3.
I shouldn't use nicotine replacement products, because they're just as bad as the nicotine in cigarettes.
True
False
I'm not sure
You're right. Nicotine is addictive. But by itself, it's not nearly as harmful as smoking. Tars, carbon monoxide, and other toxic chemicals in tobacco cause the harmful effects.
Decide what's next
1.
Do you understand the options available to you?
2.
Are you clear about which benefits and side effects matter most to you?
3.
Do you have enough support and advice from others to make a choice?
Certainty
1.
How sure do you feel right now about your decision?
Not sure at all
Somewhat sure
Very sure
2.
Check what you need to do before you make this decision.
I'm ready to take action.
I want to discuss the options with others.
I want to learn more about my options.
3.
Use the following space to list questions, concerns, and next steps.
Credits and references
Credits
Author
Debby Golonka, MPH
Editor
Susan Van Houten, RN, BSN, MBA
Associate Editor
Pat Truman, MATC
Primary Medical Reviewer
Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer
John Hughes, MD - Psychiatry
References
Citations
Stead LF, et al. (2008). Nicotine replacement therapy for smoking cessation. Cochrane Database of Systematic Reviews (1).
Varenicline (Chantix) for tobacco dependence (2006). Medical Letter on Drugs and Therapeutics, 48(1241/1242): 66–68.
Drugs for tobacco dependence (2008). Treatment Guidelines From The Medical Letter, 6(73):
61–66.
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.
Stead LF, et al. (2008). Nicotine replacement therapy for smoking cessation. Cochrane Database of Systematic Reviews (1).
Varenicline (Chantix) for tobacco dependence (2006). Medical Letter on Drugs and Therapeutics, 48(1241/1242): 66–68.
Drugs for tobacco dependence (2008). Treatment Guidelines From The Medical Letter, 6(73):
61–66.
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