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Nicotine dependence - Addiction Nicotin
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Addictions & Substance Use

Treatment

The approved effective medications to help you stop smoking fall into two categories — nicotine replacement therapy and non-nicotine medications. Using one of these medications generally doubles your chances of quitting. The best-tested treatment available to help you stop smoking is based on psychological support in addition to medications.

Combining medications with follow-up visits to your doctor for support and counseling is usually more successful than if you try to stop on your own. If you've tried a medication on your own but haven't been successful in quitting, talk to your doctor about it. He or she can help you move in the right direction by adjusting the dose of your medication, recommending a different medication, or using a combination of medications. Quitting smoking is possible, even though it may take more than a few tries.

Nicotine replacement therapy
Most nicotine replacement products are available over-the-counter:

  • Nicotine patch (Nicoderm CQ, Nicotrol, Habitrol).The patch delivers nicotine through your skin and into your bloodstream. You wear a new patch each day on your upper body. The treatment period may last for 6 or 10 weeks. Don't be in a hurry to stop using the patch, especially if you've stopped smoking or dramatically reduced your smoking. If you haven't been able to stop smoking completely after the first week or so of treatment, ask your doctor for help in adjusting the dose of the patch or adding another medication. Nicoderm CQ and Nicotrol are available over-the-counter; Habitrol is available by prescription.

  • Nicotine gum (Nicorette). This gum-like resin delivers nicotine to your blood through the lining of your mouth. It's available in a 2-milligram dose for regular smokers (24 cigarettes or less daily) and a 4-milligram dose for heavy smokers (25 cigarettes or more daily). You usually chew 10 to 15 pieces a day, and the treatment period generally lasts about 12 weeks.

  • Nicotine lozenge (Commit). This tablet dissolves in your mouth and, like nicotine gum, delivers nicotine through the lining of your mouth. The lozenges are also available in 2- and 4-milligram doses.

These nicotine replacement products are available by prescription:

  • Nicotine nasal spray (Nicotrol NS).The nicotine in this product, sprayed directly into each nostril, is absorbed through your nasal membranes into veins, transported to your heart and then sent to your brain. It's a quicker delivery system than the gum or patch.

  • Nicotine inhaler (Nicotrol inhaler).This device looks something like a cigarette holder. You puff on it, and it gives off nicotine vapors in your mouth. You absorb the nicotine through the lining in your mouth, where it then enters your bloodstream and goes to your brain, relieving withdrawal symptoms.

  • Non-nicotine medication
    The antidepressant drug bupropion, which doesn't contain nicotine, increases the level of dopamine, the chemical that's also boosted by nicotine, in your brain. As with many medications, bupropion (Wellbutrin, Zyban) has side effects, including sleep disturbance, headache and dry mouth. If you have a history of seizures or serious head trauma, such as a skull fracture, don't use this drug. Another antidepressant that may help is nortriptyline (Aventyl, Pamelor).

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This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.
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