Quitting smoking is hard, but quit-smoking aids can boost your chance of success.

By Mayo Clinic Staff

Want to stop smoking? Several quit-smoking products approved by the Food and Drug Administration (FDA) can help you stop for good.

Using smoking-cessation products can greatly increase your chance of success. Only about 5 percent of people who try to quit tobacco succeed without a quit-smoking product. But more than 30 percent succeed when using one.

Your chance of successfully quitting is even better when you combine behavior therapy with one or more quit-smoking products. You're more than twice as likely to quit smoking if you use prescription medication and professional support than if you try to quit on your own.

Some quit-smoking products are known as nicotine replacement therapy because they contain varying amounts of nicotine. Some of these nicotine replacement therapies require a prescription, but others don't. There are two approved quit-smoking medications that don't contain nicotine, and both are available only by prescription.

Any of these products 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 products without a prescription, it's best to consult your doctor first. Together you can explore which ones might be right for you, when to start taking them, and possible risks and side effects.

Electronic cigarettes have gotten a lot of attention recently as an alternative way to quit smoking traditional cigarettes. However, more studies are needed to determine the effectiveness of electronic cigarettes for smoking cessation and the long-term safety of these devices.

Overview

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.

Pros

The nicotine patch:

  • Is available in various doses without a prescription
  • Is easy to use
  • Can control nicotine cravings and withdrawal symptoms for 24 hours at a time
  • Can be used in combination with other quit-smoking aids
  • Can be gradually tapered off as your cravings and withdrawal symptoms decrease

Cons

The nicotine patch:

  • Can't quickly adjust the amount of nicotine you receive 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.
  • May cause nausea. A lower-dosage patch may help.
  • May cause skin itching, rash and irritation where it's applied. To minimize potential skin irritation, avoid putting the patch in the same place more than once every two weeks or so.
  • Can cause sleep disturbances and vivid dreams. Removing the patch at night may help.
  • Must be replaced every 24 hours.

Cautions

If you have certain skin conditions, such as eczema or psoriasis, you may more easily develop skin irritation if you use the patch.

Timeline

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 often used in combination with the nicotine patch and other quit-smoking medications. When you first start using nicotine gum, you can use a piece every one to two hours, up to 24 pieces a day.

You must follow a specific biting technique for nicotine gum to work effectively:

  • To release nicotine from the gum, bite a piece until it has a peppery taste or you notice a tingly sensation in your mouth
  • 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, then discard the gum because all the nicotine in it has been used

Pros

Nicotine gum:

  • Is available without a prescription in two doses — 2 milligrams (mg) or 4 mg
  • Can control the sudden nicotine cravings and withdrawal symptoms that you might experience while using other quit-smoking medications

Cons

Nicotine gum:

  • Must be used repeatedly throughout the day to control cravings or withdrawal symptoms
  • Can cause side effects such as mouth irritation, nausea, stomach upset, excess saliva and jaw soreness from too much biting

Cautions

Nicotine gum can damage or stick to dental appliances.

Timeline

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.

Overview

Nicotine lozenges are tablets that contain a small amount of nicotine (2 mg or 4 mg). 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.

As with nicotine gum, nicotine lozenges are often used in combination with the nicotine patch and other quit-smoking medications. You can generally use up to 20 lozenges a day.

Pros

Nicotine lozenges:

  • Are available without a prescription
  • Can control the sudden nicotine cravings and withdrawal symptoms that you might experience while using other quit-smoking medications
  • Are available as mini-lozenges that deliver nicotine more rapidly
  • Don't require chewing and don't stick to dental appliances

Cons

Nicotine lozenges:

  • Must be used repeatedly throughout the day to control cravings or withdrawal symptoms
  • Can cause side effects including nausea, indigestion, heartburn, throat irritation or hiccups

Timeline

Nicotine lozenges are recommended for about 12 weeks. Reduce the number of times a day you use the lozenges as your cravings and withdrawal symptoms decrease.

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.

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.

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.

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.

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