Nicotine inhaler

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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. 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 is short acting, which means it can control sudden nicotine cravings and withdrawal symptoms for short periods of time. You 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. The inhaler also keeps your hands busy, which can help with cigarette cravings. The nicotine inhaler is sometimes used in combination with the nicotine patch and other quit-smoking medications.

Cons

The inhaler is available only by prescription. You must use the nicotine inhaler repeatedly throughout the day to control cravings or withdrawal symptoms. The nicotine inhaler may cause coughing and mouth or throat irritation.

Cautions

Check with your doctor before using the nicotine inhaler if you have any lung disease, such as asthma. Avoid eating or drinking anything but water for 15 minutes before use or during use to prevent nicotine absorption problems.

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 a spray in each nostril one to three times an hour.

Pros

The nicotine nasal spray is short acting, which means it can control sudden nicotine cravings and withdrawal symptoms for short periods of time. The nasal spray also works faster than does nicotine gum, lozenges and the inhaler. You control the dose by using the spray as needed throughout the day. The nicotine nasal spray also can be used with the nicotine patch and other quit-smoking medications.

Cons

Nicotine nasal spray is available only by prescription. It may be inconvenient, since you must use the nasal spray repeatedly throughout the day to control cravings or withdrawal symptoms. Side effects include nasal, sinus and throat irritation, watery eyes, sneezing, and coughing. These effects typically go away with regular use over five to seven days. The nasal spray also poses a slight risk of dependency.

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 an hour at first, gradually tapering to none.

Bupropion (Zyban)

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Overview

Bupropion (Zyban) is a prescription medication classified as a type of antidepressant. A sustained-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.

Pros

Bupropion is a pill, so it's relatively easy to use. It can be used in combination with any nicotine replacement medication.

Cons

Bupropion is available only by prescription. Because it takes five to seven days to achieve effective levels in the bloodstream, you typically should start taking bupropion a week or two before you quit smoking. Side effects may include insomnia, agitation, headache and dry mouth. Also, you must remember to take the pill two times a day.

Cautions

In 2009, the Food and Drug Administration (FDA) required bupropion to carry a black box warning — the strongest safety warning that the FDA can issue about a prescription medication. The warning is required because bupropion may be associated with serious mental health problems either while taking it or after stopping it, including an increased risk of suicidal thoughts or behavior, hostility, and depression. If you take bupropion, report any changes in mood or behavior to your doctor immediately and stop taking the medication. Bupropion isn't appropriate if you have a seizure or eating disorder, if you've lost consciousness for more than an hour because of head trauma, if you're already taking a medication containing bupropion, or if you take a type of antidepressant known as a monoamine oxidase inhibitor.

Timeline

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

Varenicline (Chantix)

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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.

Pros

Varenicline is a pill, so it's relatively easy to use. It can be used in combination with any nicotine replacement medication.

Cons

Varenicline is available only by prescription. Because it takes several days to reach effective levels in the blood, you typically should start taking varenicline a week or two before you quit smoking. Also, you must remember to take the pill two times every day. Side effects can include nausea, vision trouble, fainting, severe skin reactions, vivid or strange dreams, and impairment of the ability to drive or operate heavy machinery. Some studies have shown an increase in road accidents and falls among people taking varenicline.

Cautions

In July 2009, the FDA required varenicline to carry a black box warning — the strongest safety warning that the FDA can issue about a prescription medication. The warning is required because varenicline may be associated with serious mental health problems either while taking it or after stopping it, including an increased risk of suicidal thoughts or behavior, hostility, and depression. If you take varenicline, report any changes in mood or behavior to your doctor immediately and stop taking the medication. 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 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.

Mar. 06, 2014 See more In-depth