Quit-smoking basics (10)
- Quitting smoking: 10 ways to resist tobacco cravings
- Quit-smoking products: Boost your chance of quitting for good
- Chewing tobacco: Not a safe alternative to cigarettes
- see all in Quit-smoking basics
Quit-smoking action plan (5)
- Smoking cessation: Creating a quit-smoking plan
- Quit smoking: Proven strategies to help you quit
- Stress symptoms: Effects on your body, feelings and behavior
- see all in Quit-smoking action plan
Living smoke-free (3)
- Stress management: Re-examine your stress reactions
- Support groups: Make connections, get help
- Relaxation techniques: Try these steps to reduce stress
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Quit-smoking products: Boost your chance of quitting for good
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 products.
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 three sprays an hour at first, gradually tapering to none.
Bupropion (Zyban)
Overview
Bupropion 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.
Cons
Bupropion is available only by prescription, including under the brand name Zyban. 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. Rarely, a severe allergic reaction or seizure can occur. Also, you must remember to take the pill two times a day.
Cautions
In July 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 (MAOI).
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)
Overview
Varenicline 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.
Cons
Varenicline is available only by prescription, including under the brand name Chantix. 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.
Previous page(2 of 2)
- Treating tobacco use and dependence: 2008 update. Rockville, Md.: U.S. Department of Health and Human Services. http://www.guideline.gov/summary/summary.aspx?doc_id=12520&nbr=6444&ss=6&xl=999. Accessed Dec. 9, 2010.
- Stead LF, et al. Nicotine replacement therapy for smoking cessation (review). Cochrane Database of Systematic Reviews. 2009:CD000146. http://www2.cochrane.org/reviews. Accessed Dec. 9, 2010.
- Nicotine patch fact sheet. Smokefree.gov. http://www.smokefree.gov/mg-nicotine_patch.aspx. Accessed Dec. 9, 2010.
- Rennard SI, et al. Management of smoking cessation in adults. http://www.uptodate.com/home/index.html. Accessed Dec. 9, 2010.
- Public health alert: Important information on Chantix (varenicline). U.S. Food and Drug Administration. http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/DrugSafetyInformationforHeathcareProfessionals/PublicHealthAdvisories/ucm051136.htm. Accessed Dec. 9, 2010.
- Ossip DJ, et al. Adverse effects with use nicotine replacement therapy among quitline clients. Nicotine & Tobacco Research. 2009;11:408.
- Nicotine gum fact sheet. Smokefree.gov. http://www.smokefree.gov/mg-nicotine_gum.aspx. Accessed Dec. 9, 2010.
- Nicotine lozenges fact sheet. Smokefree.gov. http://www.smokefree.gov/mg-nicotine_lozenges.aspx. Accessed Dec. 9, 2010.
- Nicotine inhaler fact sheet. Smokefree.gov. http://www.smokefree.gov/mg-nicotine_inhaler.aspx. Accessed Dec. 9, 2010.
- Nicotine nasal spray fact sheet. Smokefree.gov. http://www.smokefree.gov/mg-nicotine_spray.aspx. Dec. 9, 2010.
- Varenicline fact sheet. Smokefree.gov. http://www.smokefree.gov/mg-varenicline.aspx. Accessed Dec. 9, 2010.
- Bupropion fact sheet. Smokefree.gov. http://www.smokefree.gov/mg-bupropion.aspx. Accessed Dec. 9, 2010.
- Barbara Woodward Lips Patient Education Center. Medications to help you stop using tobacco. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2008.
- Dale LC (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 12, 2011.
- FDA: Boxed warning on serious mental health events to be required for Chantix and Zyban. U.S. Food and Drug Administration. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm170100.htm. Accessed Dec. 9, 2010.
- Hurt R, et al. Treating tobacco dependence in a medical setting. CA: A Cancer Journal for Clinicians. 2009;5:314.
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