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Decision PointQuitting smoking: Should I use medicine?You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them. Quitting smoking: Should I use medicine? Get the facts Your options
Key points to remember
FAQs
What are the medicines?Your doctor may prescribe varenicline (Chantix) or bupropion (Zyban) to help you cope with cravings for tobacco. These medicines are pills that don't contain nicotine. You also can use nicotine replacement products, which do contain nicotine. Medicines that don't have nicotine
Nicotine replacement products Nicotine replacement gives your body some nicotine to help reduce withdrawal symptoms and cravings. Nicotine is addictive. But this treatment has about one-third to one-half the amount of nicotine in most cigarettes. It also delivers the nicotine slowly, so it's not as addicting as the nicotine in cigarettes. And these products don't have the harmful tars, carbon monoxide, and other toxic chemicals that are in tobacco. There are several types of nicotine replacement:
Nicotine nasal spray (Nicotrol) is another nicotine replacement. It is not widely used. See your doctor about this medicine. You can buy nicotine gum, patches, and lozenges without a prescription. You need a prescription to buy inhalers. You may be able to use a couple of these products at the same time, such as a patch and gum. But talk to your doctor first to make sure it's okay to mix nicotine medicines. People younger than age 18 can't buy the over-the-counter products, but a doctor may prescribe them. Talk to your doctor if you're pregnant or planning to become pregnant and want to stop smoking. Most doctors will recommend that you try other ways to stop smoking before using nicotine replacement. Be sure to talk your doctor before using these products if you have a health condition, such as mental illness or heart problems. How well do medicines work?Medicines can double your chances of quitting.1
For more information, see the Strategies and Skills for Quitting section of the topic Quitting Smoking. What are the risks of using medicine to quit smoking?Medicines that don't have nicotine The most common side effects of varenicline (Chantix) include:
Some people also have side effects such as nausea, headaches, and dizziness. Varenicline may cause some mental illness symptoms, such as depression. If you have a mental illness, be sure to talk to your doctor before using these products. Some people who take bupropion SR (Zyban) have:
There is a small risk of having seizures when you use bupropion. The risk increases if you have had a head injury or seizures. Tell your doctor about all the medicines you take. When you stop smoking, there may be a change in how other medicines work for you. FDA Warning. The U.S. Food and Drug Administration (FDA) warns that people who are taking bupropion (Zyban) or varenicline (Chantix) and who experience any serious or unusual changes in mood or behavior or who feel like hurting themselves or someone else should stop taking the medicine and call a doctor right away. Friends or family members who notice these changes in behavior in someone who is taking bupropion (Zyban) or varenicline (Chantix) for smoking cessation should tell the person their concerns and advise him or her to stop taking the drug and call a doctor right away. Nicotine replacement products The side effects depend on the type of nicotine replacement product.
Why might your doctor recommend that you use medicine?Your doctor might recommend that you use medicine to stop smoking if:
Compare your options Compare
Use medicines to quit
smoking Use medicines to quit
smoking
Don't use medicines
Don't use medicines
Personal Stories Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide. Personal stories from people who have quit smokingThese stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions. I started smoking when I was in the military. But it is affecting my health, and I want to quit. I've tried the patch, gum, and cold-turkey methods to quit, and they didn't work. So I talked with my doctor about quitting, and he suggested that I try using Chantix. He also recommended that I have counseling and join a support group. It's been a little over a month since I started Chantix, and so far it is helping with my craving to smoke. Talking in counseling is also helpful. I think I finally am going to be able to quit. Dave, age 42 I thought about taking medicine to quit smoking, but I already take several other medicines for health problems. I just didn't want to take another prescription medicine and take the chance that it might cause problems. So I decided to try the nicotine patch. I set a date and started planning for the physical effects of quitting, like having munchies around and cleaning my car and house. I started with the largest patch available. It was great because the withdrawal symptoms were hardly noticeable. Then I went to the medium patch and finally the smallest patch. Now I don't smoke anymore. Alanna, age 44 I started smoking at 15. I always thought I could quit at any time and had tried to quit dozens of times. But then I'd start craving a smoke, and I'd go back to cigarettes. A few years ago, my doctor suggested I try taking Zyban and nicotine gum. It was great, because between the pills and the gum, the withdrawal symptoms were hardly noticeable. I was done with the gum after the first few weeks, but I ended up staying on the pills for 6 months. But using both worked for me, and I haven't smoked for 2 years. Carlo, age 52 My friends pushed me to quit smoking and suggested I talk to my doctor about getting some medicine to help. But I just wasn't comfortable with the idea of taking medicine. I have a strong will, and when I put my mind to doing something, I can usually do it. So I took my doctor's advice to have professional counseling to help improve my chances of success. I quit smoking—cold turkey—5 months ago. All my friends are really surprised that I could quit like that. It has been tough at times fighting the cravings, but it has worked. Kesia, age 35 For more information, see the topic Quitting Smoking. What matters most to you? Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements. Reasons to use medicine to quit smoking Reasons not to use medicine I want to use medicine if it can increase my chances of quitting. I don't like using medicine. More important Equally important More important I'm not concerned about possible side effects. I am very concerned about side effects. More important Equally important More important I'm not worried about how I will pay for the medicine. I'm worried about how I will pay for the medicine. More important Equally important More important My other important reasons: My other important reasons: More important Equally important More important Where are you leaning now? Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now. Using medicine NOT using medicine Leaning toward Undecided Leaning toward What else do you need to make your decision? Check the facts 1.
Using medicine can double my chances of quitting smoking.
2.
My chances of quitting are even better if I get counseling along with using medicine.
3.
I shouldn't use nicotine replacement products, because they're just as bad as the nicotine in cigarettes.
Decide what's next 1.
Do you understand the options available to you? 2.
Are you clear about which benefits and side effects matter most to you? 3.
Do you have enough support and advice from others to make a choice? Certainty 1.
How sure do you feel right now about your decision? Not sure at all Somewhat sure Very sure 2.
Check what you need to do before you make this decision. 3.
Use the following space to list questions, concerns, and next steps. Your Summary Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision. Your decision |
| Author | Debby Golonka, MPH |
| Editor | Susan Van Houten, RN, BSN, MBA |
| Associate Editor | Pat Truman, MATC |
| Primary Medical Reviewer | Kathleen Romito, MD - Family Medicine |
| Specialist Medical Reviewer | John Hughes, MD - Psychiatry |
- Stead LF, et al. (2008). Nicotine replacement therapy for smoking cessation. Cochrane Database of Systematic Reviews (1).
- Varenicline (Chantix) for tobacco dependence (2006). Medical Letter on Drugs and Therapeutics, 48(1241/1242): 66–68.
- Drugs for tobacco dependence (2008). Treatment Guidelines From The Medical Letter, 6(73): 61–66.
Quitting smoking: Should I use medicine?
- Get the facts
- Compare your options
- What matters most to you?
- Where are you leaning now?
- What else do you need to make your decision?
1. Get the Facts
Your options
- Use medicine to help you quit smoking. This may include nicotine replacement products.
- Don't use medicine.
Key points to remember
- Using medicines can double your chances of quitting smoking.1 They can relieve nicotine craving and withdrawal symptoms.
- Getting counseling, along with using medicine, can increase your chances of quitting even more.
- If you smoke fewer than 10 cigarettes a day, you may not need medicines to help you quit smoking.
- It's rare for someone to get addicted to nicotine medicines, because the nicotine is released slowly into your bloodstream.
- The side effects of nicotine replacement products depend on the type of product. For example, a patch can make your skin red and itchy. Medicines in pill form can cause nausea, dry mouth, and trouble sleeping. For most people, the side effects aren't bad enough to make them stop using the medicines.
- Nicotine medicines have less nicotine than cigarettes. And by itself, nicotine is not nearly as harmful as smoking. The tars, carbon monoxide, and other toxic chemicals in tobacco cause the harmful effects.
- Many insurance companies will pay for all or part of the cost of medicines used to quit smoking.
What are the medicines?
Your doctor may prescribe varenicline (Chantix) or bupropion (Zyban) to help you cope with cravings for tobacco. These medicines are pills that don't contain nicotine. You also can use nicotine replacement products, which do contain nicotine.
Medicines that don't have nicotine
- Varenicline (Chantix) blocks the effects of nicotine and reduces cravings and withdrawal symptoms. If you start smoking again while you are taking the medicine, you won't feel as satisfied. This improves your chances of quitting. You start taking the medicine about a week before you quit smoking, and you take it for 12 to 24 weeks. You take it 2 times a day, after meals.
- Bupropion SR (Zyban) can help balance chemicals in your brain to reduce your withdrawal symptoms. Doctors also prescribe this medicine (under the brand name Wellbutrin) to treat depression. But it can help you stop smoking even if you don't have depression. You start taking bupropion daily about 1 to 2 weeks before you quit smoking. This builds up the level of medicine in your body. You keep taking it for 7 to 12 weeks after you stop smoking.
- Nortriptyline (Aventyl, Pamelor) and clonidine (Catapres) may be prescribed if the other medicines don't work or you can't take them.
Nicotine replacement products
Nicotine replacement gives your body some nicotine to help reduce withdrawal symptoms and cravings. Nicotine is addictive. But this treatment has about one-third to one-half the amount of nicotine in most cigarettes. It also delivers the nicotine slowly, so it's not as addicting as the nicotine in cigarettes. And these products don't have the harmful tars, carbon monoxide, and other toxic chemicals that are in tobacco.
There are several types of nicotine replacement:
- Gum and lozenges slowly release nicotine into your mouth.
- Patches stick to your skin and slowly release nicotine into your bloodstream.
- An inhaler has a holder that contains nicotine. It delivers a puff of nicotine vapor into your mouth and throat.
Nicotine nasal spray (Nicotrol) is another nicotine replacement. It is not widely used. See your doctor about this medicine.
You can buy nicotine gum, patches, and lozenges without a prescription. You need a prescription to buy inhalers. You may be able to use a couple of these products at the same time, such as a patch and gum. But talk to your doctor first to make sure it's okay to mix nicotine medicines. People younger than age 18 can't buy the over-the-counter products, but a doctor may prescribe them.
Talk to your doctor if you're pregnant or planning to become pregnant and want to stop smoking. Most doctors will recommend that you try other ways to stop smoking before using nicotine replacement.
Be sure to talk your doctor before using these products if you have a health condition, such as mental illness or heart problems.
How well do medicines work?
Medicines can double your chances of quitting.1
- Some studies have found that varenicline (Chantix) works better than bupropion SR (Zyban).2 But every person is different. So one medicine may work better for you than the other.
- All forms of nicotine replacement products work about equally well when used in the right way.3
- Your chances of quitting smoking are even better if you combine medicines with other help, such as counseling.1
For more information, see the Strategies and Skills for Quitting section of the topic Quitting Smoking.
What are the risks of using medicine to quit smoking?
Medicines that don't have nicotine
The most common side effects of varenicline (Chantix) include:
- Nausea.
- Increased dreaming.
- Insomnia.
Some people also have side effects such as nausea, headaches, and dizziness.
Varenicline may cause some mental illness symptoms, such as depression. If you have a mental illness, be sure to talk to your doctor before using these products.
Some people who take bupropion SR (Zyban) have:
- Dry mouth.
- Trouble sleeping.
There is a small risk of having seizures when you use bupropion. The risk increases if you have had a head injury or seizures.
Tell your doctor about all the medicines you take. When you stop smoking, there may be a change in how other medicines work for you.
FDA Warning. The U.S. Food and Drug Administration (FDA) warns that people who are taking bupropion (Zyban) or varenicline (Chantix) and who experience any serious or unusual changes in mood or behavior or who feel like hurting themselves or someone else should stop taking the medicine and call a doctor right away.
Friends or family members who notice these changes in behavior in someone who is taking bupropion (Zyban) or varenicline (Chantix) for smoking cessation should tell the person their concerns and advise him or her to stop taking the drug and call a doctor right away.
Nicotine replacement products
The side effects depend on the type of nicotine replacement product.
- Nicotine patches can cause itching and redness where you put the patch. If you use a 24-hour patch, you may have trouble sleeping or have very vivid dreams. This is because your brain isn't used to getting nicotine when you're sleeping. Taking off the patch after 8 p.m. may help ease your sleep problems.
- Nicotine gum can cause an upset stomach (nausea) or heartburn. Gum is not a good choice for people who have dentures or problems with their jaw joint (TM disorders).
- Nicotine lozenges can cause an upset stomach, hiccups, heartburn, headaches, and gas.
- Nicotine inhalers can cause a cough, a scratchy throat, and an upset stomach. An inhaler may not be a good choice if you have asthma, allergies, or a sinus problem.
Why might your doctor recommend that you use medicine?
Your doctor might recommend that you use medicine to stop smoking if:
- You have tried on your own to stop smoking but you weren't able to stop.
- You smoke more than 10 cigarettes a day.
2. Compare Options
| Use medicines to quit smoking | Don't use medicines | |
|---|---|---|
| What is usually involved? |
|
|
| What are the benefits? |
|
|
| What are the risks and side effects? |
|
|
Personal stories
Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.
For more information, see the topic Quitting Smoking.
Personal stories from people who have quit smoking
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"I started smoking when I was in the military. But it is affecting my health, and I want to quit. I've tried the patch, gum, and cold-turkey methods to quit, and they didn't work. So I talked with my doctor about quitting, and he suggested that I try using Chantix. He also recommended that I have counseling and join a support group. It's been a little over a month since I started Chantix, and so far it is helping with my craving to smoke. Talking in counseling is also helpful. I think I finally am going to be able to quit. "
— Dave, age 42
"I thought about taking medicine to quit smoking, but I already take several other medicines for health problems. I just didn't want to take another prescription medicine and take the chance that it might cause problems. So I decided to try the nicotine patch. I set a date and started planning for the physical effects of quitting, like having munchies around and cleaning my car and house. I started with the largest patch available. It was great because the withdrawal symptoms were hardly noticeable. Then I went to the medium patch and finally the smallest patch. Now I don't smoke anymore. "
— Alanna, age 44
" I started smoking at 15. I always thought I could quit at any time and had tried to quit dozens of times. But then I'd start craving a smoke, and I'd go back to cigarettes. A few years ago, my doctor suggested I try taking Zyban and nicotine gum. It was great, because between the pills and the gum, the withdrawal symptoms were hardly noticeable. I was done with the gum after the first few weeks, but I ended up staying on the pills for 6 months. But using both worked for me, and I haven't smoked for 2 years. "
— Carlo, age 52
"My friends pushed me to quit smoking and suggested I talk to my doctor about getting some medicine to help. But I just wasn't comfortable with the idea of taking medicine. I have a strong will, and when I put my mind to doing something, I can usually do it. So I took my doctor's advice to have professional counseling to help improve my chances of success. I quit smoking—cold turkey—5 months ago. All my friends are really surprised that I could quit like that. It has been tough at times fighting the cravings, but it has worked. "
— Kesia, age 35
3. Your Feelings
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to use medicine to quit smoking
Reasons not to use medicine
I want to use medicine if it can increase my chances of quitting.
I don't like using medicine.
I'm not concerned about possible side effects.
I am very concerned about side effects.
I'm not worried about how I will pay for the medicine.
I'm worried about how I will pay for the medicine.
My other important reasons:
My other important reasons:
4. Your Decision
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Using medicine
NOT using medicine
5. Quiz Yourself
Check the facts
1. Using medicine can double my chances of quitting smoking.
- True
- False
- I'm not sure
2. My chances of quitting are even better if I get counseling along with using medicine.
- True
- False
- I'm not sure
3. I shouldn't use nicotine replacement products, because they're just as bad as the nicotine in cigarettes.
- True
- False
- I'm not sure
Decide what's next
1. Do you understand the options available to you?
2. Are you clear about which benefits and side effects matter most to you?
3. Do you have enough support and advice from others to make a choice?
Certainty
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
- I'm ready to take action.
- I want to discuss the options with others.
- I want to learn more about my options.
3. Use the following space to list questions, concerns, and next steps.
| Author | Debby Golonka, MPH |
| Editor | Susan Van Houten, RN, BSN, MBA |
| Associate Editor | Pat Truman, MATC |
| Primary Medical Reviewer | Kathleen Romito, MD - Family Medicine |
| Specialist Medical Reviewer | John Hughes, MD - Psychiatry |
- Stead LF, et al. (2008). Nicotine replacement therapy for smoking cessation. Cochrane Database of Systematic Reviews (1).
- Varenicline (Chantix) for tobacco dependence (2006). Medical Letter on Drugs and Therapeutics, 48(1241/1242): 66–68.
- Drugs for tobacco dependence (2008). Treatment Guidelines From The Medical Letter, 6(73): 61–66.
Last Updated:July 22, 2009
Author:Debby Golonka, MPH
Medical Review:Kathleen Romito, MD - Family Medicine & John Hughes, MD - Psychiatry
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