Quit-smoking medicines: Boost your chance of success
Quitting smoking is hard, but many quit-smoking medications are available to boost your chance of success.By Mayo Clinic Staff
Want to stop smoking? Several quit-smoking medications have been approved by the Food and Drug Administration (FDA) and can help you stop for good.
Using a quit-smoking medication can greatly increase your chance of success. Only about 5 percent of people who try to quit tobacco succeed without a quit-smoking medication. But more than 30 percent can succeed when using a quit-smoking medication. Your chance of successfully quitting is even better when you combine behavior therapy with use of one or more quit-smoking medications.
Types of quit-smoking medications
Some quit-smoking medications are known as nicotine replacement therapy because they contain small amounts of nicotine. Some do not require a prescription, but some do. Others are prescription medications without nicotine. Either type can help reduce nicotine cravings and withdrawal symptoms, making it more likely that you'll stop smoking for good.
Although you can buy some quit-smoking medications without a prescription, it's best to consult your doctor before you try them. There's not a single best quit-smoking medication for everyone. Together with your doctor, you can explore which quit-smoking medications or combinations of medications may be right for you, when to start taking them, and possible risks and side effects.
The nicotine patch is a small, self-adhesive patch that releases a slow, steady amount of nicotine into your body through your skin. You apply a new nicotine patch every day on a hairless area of skin between your waist and neck, such as your upper arm or chest.
The nicotine patch is available without a prescription in various doses. The patch is easy to use. The nicotine patch is long acting, controlling nicotine cravings and withdrawal symptoms for 24 hours at a time. You can gradually taper off the nicotine patch as your cravings and withdrawal symptoms decrease. The patch may be used in combination with other quit-smoking aids.
You can't quickly adjust the amount of nicotine if you have sudden cravings or withdrawal symptoms. However, you may be able to use a second quit-smoking medication along with the patch when a craving arises. The patch may cause skin itching, rash and irritation where it's applied. Patches also may cause sleep disturbances and vivid dreams. Removing the patch at night may help. Patches must be replaced every 24 hours. To minimize potential skin irritation, avoid putting the patch in the same place more than once every two weeks or so.
If you have certain skin conditions, such as eczema or psoriasis, you may more easily develop skin irritation if you use the patch.
It's typical to use the nicotine patch for eight to 12 weeks. You may need to use it longer if cravings or withdrawal symptoms continue. Talk to your health care provider if you think you need to use it longer.
Nicotine gum contains a small amount of nicotine. The nicotine enters your body as it's absorbed through the lining of your mouth when you use the gum according to directions.
Nicotine gum is available without a prescription in two doses. It's short acting, which means it can control sudden nicotine cravings and withdrawal symptoms for short periods of time. When you first start using nicotine gum, you can use a piece every one to two hours, up to 24 pieces a day. Nicotine gum comes in several flavors. It's often used in combination with the nicotine patch and other quit-smoking medications.
You must use nicotine gum repeatedly throughout the day to control cravings or withdrawal symptoms. Nicotine gum may only take the edge off cravings, not make them go away completely.
You must follow a specific biting technique for nicotine gum to work effectively. Don't chew it like chewing gum. To release nicotine from the gum, bite a piece until it has a peppery taste or you notice a tingly sensation in your mouth. Then, to let the nicotine absorb, hold the gum between your gumline and cheek until the taste or tingly sensation stops. To release more nicotine, bite and hold again. Repeat the cycle for about 30 minutes, and then discard the gum because all the nicotine in it has been used. Side effects include jaw soreness from too much biting, as well as mouth irritation, nausea, stomach upset and excess saliva.
Nicotine gum may stick to dentures or other dental work. Avoid eating or drinking anything but water during use and for 15 minutes before to prevent problems with poor nicotine absorption.
Nicotine gum is recommended for up to 12 weeks. You can start by using a piece every hour or two, and then gradually reduce the frequency as cravings and withdrawal symptoms decrease.
Nicotine lozenges are tablets that contain a small amount of nicotine. You place a lozenge between your gumline and cheek and suck it slowly, allowing it to dissolve. The nicotine enters your bloodstream as it's absorbed through the lining of your mouth.
Nicotine lozenges are available without a prescription in different doses and flavors. One type is called a minilozenge, and it's intended to get nicotine into your system more quickly. All lozenges are short acting, which means they can control sudden nicotine cravings and withdrawal symptoms for short periods of time. You can generally use up to 20 lozenges a day. Nicotine lozenges are often used in combination with the nicotine patch and other quit-smoking medications.
You must use nicotine lozenges repeatedly throughout the day to control cravings or withdrawal symptoms. Nicotine lozenges may sometimes cause nausea, indigestion, heartburn, throat irritation or hiccups.
Avoid eating or drinking anything but water for 15 minutes before use or during use to prevent problems with reduced nicotine absorption.
Nicotine lozenges are recommended for about 12 weeks. Reduce how many times a day you use the lozenges as your cravings and withdrawal symptoms decrease.
Mar. 06, 2014
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- Treating tobacco use and dependence: 2008 update. Rockville, Md.: U.S. Department of Health and Human Services. http://www.guideline.gov/content.aspx?id=12520. Accessed Nov. 13, 2013.
- Stead LF, et al. Nicotine replacement therapy for smoking cessation. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000146.pub4/abstract. Accessed Nov. 13, 2013.
- Explore medications. Smokefree.gov. http://smokefree.gov/explore-medications. Accessed Nov. 13, 2013.
- Rennard SI, et al. Overview of smoking cessation management in adults. http://www.uptodate.com/home. Accessed Nov. 13, 2013.
- AskMayoExpert. Tobacco use. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2013.
- Ossip DJ, et al. Adverse effects with use of nicotine replacement therapy among quitline clients. Nicotine & Tobacco Research. 2009;11:408.
- Nicotine gum drug facts. National Library of Medicine. http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=394375a9-dd6d-4555-9893-930ef71caf8c. Accessed Nov. 13, 2013.
- Nicotine lozenges drug facts. National Library of Medicine. http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=fdee1637-8049-4bc5-b196-b6d854c9f9f3. Accessed Nov. 13, 2013.
- Nicotrol (nicotine inhalation system) prescribing information. New York, N.Y.: Pfizer Pharmacia & Upjohn Co.; 2008. http://www.pfizer.com/files/products/uspi_nicotrol_inhaler.pdf. Accessed Nov. 13, 2013.
- Nicotrol NS (nicotine nasal spray) prescribing information. New York, N.Y.: Pfizer Pharmacia & Upjohn Co.; 2010. http://www.pfizer.com/files/products/uspi_nicotrol.pdf. Accessed Nov. 13, 2013.
- Chantix (varenicline) prescribing information. New York, N.Y.: Pfizer Labs; 2012. http://www.fda.gov/downloads/Drugs/DrugSafety/UCM088569.pdf. Accessed Nov. 13, 2013.
- Zyban (bupropion hydrochloride) prescribing information. Greenville, N.C.: GlaxoSmithKline; 2012. http://us.gsk.com/products/assets/us_zyban.pdf. Accessed Nov. 13, 2013.
- Barbara Woodward Lips Patient Education Center. Medications to help you stop using tobacco. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2009.
- Hurt R, et al. Treating tobacco dependence in a medical setting. CA: A Cancer Journal for Clinicians. 2009;5:314.
- Rennard SI, et al. Pharmacotherapy for smoking cessation management in adults. http://www.uptodate.com/home. Accessed Nov. 13, 2013.
- Smoking cessation fact sheet. Centers for Disease Control and Prevention. http://www.cdc.gov/tobacco/data_statistics/fact_sheets/cessation/quitting/. Accessed Nov. 13, 2013.
- Nicotine patch drug facts. National Library of Medicine. http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=93b2d1b9-83c1-40b5-b6af-90c38c8d6cef. Accessed Nov. 13, 2013.