Stop Smoking Services

Medications for Nicotine Withdrawal

Medications to help people stop smoking fall into two categories — nicotine replacement therapy and non-nicotine medications. Using one of these medications generally doubles a person's chances of quitting. Mayo Clinic is active in research assessing the effectiveness of medications for smoking cessation.

Nicotine replacement therapy

Most nicotine replacement products are available over-the-counter

Nicotine patch (Nicoderm CQ, Nicotrol, Habitrol, others). The patch delivers nicotine through the skin and into the bloodstream. You wear a new patch each day on the upper body. The treatment period may last for 8 weeks or more. 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, others). This is a gum-like resin that delivers nicotine to the blood through the lining of the mouth. It's available in a 2-milligram dose for regular smokers and a 4-milligram dose for heavy smokers. People usually chew 10 to 15 pieces a day. Nicotine gum is recommended for one to three months, with a maximum of six months.

Nicotine lozenge (Commit). This is a tablet that dissolves in the mouth and, like nicotine gum, delivers nicotine through the lining of the mouth. The lozenges are also available in 2- and 4-milligram doses. The recommended dose is one lozenge every couple of hours for six weeks, then gradually increasing the interval time between lozenges over the next six weeks.

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 the nasal membranes into veins, transported to the heart and then sent to the brain. It's a quicker delivery system than gum or patch. It's usually prescribed for three-month periods, for a maximum of six months.

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

Non-nicotine medication

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

Varenicline (Chantix)
Varenicline (Chantix) is the latest addition to the arsenal of quit-smoking aids approved by the Food and Drug Administration (FDA). Like other similar products, Chantix helps ease nicotine withdrawal symptoms. But there's a twist. The drug also blocks the effects of nicotine if you begin to smoke again.

Chantix is a prescription medication sold in tablet form. It's intended to be taken for 12 weeks. If you quit smoking during that time, your doctor may prescribe Chantix for another 12 weeks to enhance long-term success. Side effects may include nausea, vomiting, gas, headache and insomnia.

Researchers found Chantix to be more effective than a placebo in helping people quit smoking. In two studies, Chantix helped more people quit smoking than did bupropion (Zyban) — the only other nicotine-free drug used as a quit-smoking aid.