Nicotine inhaler

Overview

The nicotine inhaler is a device that gives you a small dose of nicotine. When you puff on the nicotine inhaler, nicotine vapor is released from a cartridge inside the device. The nicotine enters your bloodstream as it's absorbed through the lining of your mouth and throat.

It's important to hold the vapor in your mouth for a few seconds and then blow it out — don't inhale it into your lungs.

Pros

The nicotine inhaler:

  • Can control the sudden nicotine cravings and withdrawal symptoms that you might experience while using other quit-smoking medications.
  • Allows you to control the dose of nicotine you receive. You can take as few puffs as needed to satisfy withdrawal symptoms or cravings, and save the rest of the cartridge for later.
  • Keeps your hands busy, which can help with nicotine cravings.

Cons

The nicotine inhaler:

  • Is available only by prescription
  • Must be used repeatedly throughout the day to control cravings or withdrawal symptoms
  • Might cause coughing and mouth or throat irritation

Cautions

The nicotine inhaler isn't recommended if you have a breathing condition such as asthma.

Timeline

Recommended use is six to 16 cartridges a day for six to 12 weeks, gradually tapering to none over the next six to 12 weeks.

Nicotine nasal spray

Overview

The nicotine nasal spray delivers a solution into your nostrils that contains a small dose of nicotine. The nicotine enters your body by being absorbed through the lining of your nose. The recommended dose is one to two sprays in each nostril once or twice an hour.

Pros

Nicotine nasal spray:

  • Can control the sudden nicotine cravings and withdrawal symptoms that you might experience while using other quit-smoking medications
  • Works faster than nicotine gum, lozenges and the inhaler
  • Allows you to control the dose by using the spray as needed throughout the day

Cons

Nicotine nasal spray:

  • Is available only by prescription
  • Must be used repeatedly throughout the day to control cravings or withdrawal symptoms
  • Might cause watery eyes, sneezing, coughing, and nasal, sinus and throat irritation

Cautions

Nicotine nasal spray isn't recommended if you have a nasal or sinus condition.

Timeline

Nicotine nasal spray is often used for about three to six months. Recommended use is one to two sprays in each nostril once or twice an hour.

Bupropion (Zyban)

Overview

Bupropion (Zyban) is a prescription medication classified as a type of antidepressant. An extended-release form of bupropion is approved for smoking cessation.

Unlike nicotine replacement therapy, bupropion doesn't contain nicotine. It's thought to decrease tobacco cravings and withdrawal symptoms by increasing the levels of certain brain chemicals.

It takes five to seven days for bupropion to achieve effective levels in the blood. You typically should start taking bupropion a week or two before you quit smoking.

Pros

Bupropion:

  • Is a pill, so it's relatively easy to use
  • Can be used in combination with any nicotine replacement medication
  • May reduce the weight gain many smokers experience after quitting cigarettes

Cons

Bupropion:

  • Is available only by prescription.
  • Must be taken twice a day.
  • Can cause dry mouth and insomnia, which tend to ease over time.
  • Can cause agitation, depressed mood or suicidal thoughts. If you experience these adverse effects, stop taking the medication and see your doctor.

Cautions

In 2009, the FDA required bupropion to carry a warning that some people experienced serious mental health problems either while taking it or after stopping it, including an increased risk of suicidal thoughts or behavior, hostility, and depression.

In 2016, the FDA reversed that decision based on the results of a large scientific study that found the risk of these mental health side effects was lower than expected. Thus, the FDA determined that the benefits of stopping smoking appear to outweigh the risk of side effects from the medication.

If you take bupropion, report any changes in mood or behavior to your doctor immediately and stop taking the medication.

Bupropion also isn't appropriate if you have seizures or an eating disorder.

Timeline

Bupropion is generally used for 12 weeks. But if you've successfully quit smoking, you can use it for another three to six months to reduce the risk of a smoking relapse.

Varenicline (Chantix)

Overview

Varenicline (Chantix) is a prescription medication that can help reduce cravings for tobacco and control nicotine withdrawal symptoms. It also blocks nicotine receptors in your brain, which decreases the pleasurable effects of smoking.

It takes several days for varenicline to reach effective levels in the blood. You typically should start taking varenicline a week or two before you quit smoking.

Pros

Varenicline:

  • Is a pill, so it's relatively easy to use
  • Can be used in combination with any nicotine replacement medication or bupropion

Cons

Varenicline:

  • Is available only by prescription.
  • Must be taken twice a day.
  • Can cause nausea. Taking a lower dose or taking the medication with food and water might help.
  • Can cause vivid or strange dreams.
  • Can cause agitation, depressed mood or suicidal thoughts.

Cautions

In 2009, the FDA required varenicline to carry a warning that some people experienced serious mental health problems either while taking it or after stopping it, including an increased risk of suicidal thoughts or behavior, hostility, and depression.

In 2016, the FDA reversed that decision based on the results of a large scientific study that found the risk of these mental health side effects was lower than expected. Thus, the FDA determined that the benefits of stopping smoking appear to outweigh the risk of side effects from the medication.

If you take varenicline, report any changes in mood or behavior to your doctor immediately and stop taking the medication. In addition, varenicline should be used with caution if you have severe kidney problems.

Timeline

Varenicline is typically used for 12 weeks. But if you've successfully quit smoking, you can use it for another 12 weeks to reduce the risk of a smoking relapse.

Need more help to quit smoking?

The most effective strategy to quit smoking for good is to combine a quit-smoking product with a program that includes support from professionals trained to treat tobacco dependence. Consider joining a community stop-smoking group or starting in-person or telephone counseling.

Call 800-QUIT-NOW (800-784-8669) to obtain free telephone counseling services and information about stop-smoking programs near you.

Feb. 18, 2017 See more In-depth