Medicines can help you quit smoking when you use them correctly. Nicotine replacement medicines contain gradually decreasing doses of nicotine to help reduce the headaches and irritability you may have when you quit smoking. Non-nicotine prescription medicines can also help you quit by making nicotine cravings less severe.
Your doctor or nurse can help you decide if one of these medicines might help you. Your doctor may also decide that using both a nicotine replacement medicine and a non-nicotine replacement medicine may work better for you.
When you talk to your doctor or nurse, ask how to use the medicine. Studies show that many people don't use their quit-smoking medicines correctly. If you don't use the medicine properly, it won't work well for you. The information sheet that comes with your medicine tells you exactly how to use the medicine.
Nicotine Replacement Medicines
You can't use nicotine replacement medicines if you keep smoking or use other tobacco products. The combined use of nicotine can be dangerous. You must stop smoking completely when you begin using a nicotine replacement medicine.
Nicotine replacement treatment usually lasts from two to three months. Even though you can buy many products without a prescription, talk to your doctor first about which medicine is best for you.
Nicotine Chewing Gum or Lozenges
Nicotine gum has helped people quit smoking for 20 years. You can buy the gum or lozenges in a drug store without a prescription. Be sure to read the instructions and use the gum or lozenges correctly.
- Try to chew a piece of gum or suck a lozenge every one to two hours that you're awake, but don't use more than 20 pieces per day if you use 4 mg gum or lozenges, or 30 pieces per day if you use 2 mg gum or lozenges. The number of pieces you use per day will decrease over time.
- Don't drink coffee, orange juice, cola or alcohol for 15 minutes before or while using a piece of gum or lozenge. These drinks make the nicotine replacement less powerful.
- If you don't use nicotine gum or lozenges correctly, you may have side effects such as mouth and throat discomfort.
- You may need to use nicotine gum or lozenges for three months.
You don't need a doctor's prescription to buy the nicotine patch. The patches may come in different strengths: some brands are available in 5, 10 and 15 mg strengths; others may come in 7, 14 and 21 mg strengths. Read the package to determine what strength you should start using, depending on the amount you smoke. Taper down to the lower-strength patches on the recommended schedule.
- Wear the patch on your chest or high on your arm.
- Put on a new patch every 16 or 24 hours. If you have trouble sleeping or have disturbing dreams, remove the patch when you go to bed and put on a new one as soon as you get up.
- You may swim, shower and perform physical activity with the patch.
- Side effects may include redness and soreness under the patch. To reduce these side effects, change the location of the patch each day.
To buy the nicotine spray, you need a prescription from your doctor.
- The spray goes in your nose, one or two times per hour, when you're awake.
- The spray may cause coughing, runny nose or watery eyes during the first week or two. These side effects get better over time.
- You may need to use nicotine spray for up to six months, but taper off starting at or before three months.
Non-Nicotine Prescription Medicines
Some of the major types of commonly prescribed smoking-cessation medicines are summarized in this section. For your information and reference, we have included generic names as well as major trade names to help you identify what you may be taking; however, the AHA is not recommending or endorsing any specific products. If your prescription medication isn't on this list, remember that your healthcare provider and pharmacist are your best sources of information. It's important to discuss all of the drugs you take with your doctor and understand their desired effects and possible side effects. Never stop taking a medication and never change your dose or frequency without first consulting your doctor.
Bupropion hydrochloride is a medicine for depression, but it also helps people quit smoking. Brand names include Zyban®, Wellbutrin®, Wellbutrin SR® and Wellbutrin XL® but this medication is also available as a generic.
Varenicline is a relatively new medicine that may help smokers quit. It is currently available under the brand name Chantix®.
- Both medicines work by blocking the flow of chemicals in the brain that make you want to smoke.
- Both medicines come in pill form. You start out with a low dose and gradually increase up to the full dose.
- It takes about a week for these medicines to work, so you need to start taking them before you quit smoking.
- Each of these medicines may interact differently with other medicines you're taking. Make sure your doctor and pharmacist have a complete list of all your medicines, including over-the-counter drugs, supplements and herbal medicines.
- You may need to use a non-nicotine prescription medicine for seven to 12 weeks or longer, as your doctor recommends.
- When you get ready to stop taking a non-nicotine prescription medicine, you may need to take a gradually decreasing dose before you stop completely.
- The FDA notified the public that the use of varenicline or bupropion has been associated with reports of behavior changes including hostility, agitation, depressed mood, and suicidal thoughts or actions. The FDA is requiring the manufacturers of these products to add a new Boxed Warning to the product labeling to alert healthcare professionals to this important new safety information.
- While taking these drugs, if you experience any serious and unusual changes in mood or behavior or feel like hurting yourself or someone else, you should stop taking the medicine and call you healthcare professional right away.
- Friends or family members who notice these changes in behavior in someone who is taking varenicline or bupropion for smoking cessation should tell the person their concerns and recommend that he or she stop taking the drug and call a healthcare professional right away.
- For more information about the FDA's warnings about varenicline and bupropion, read our press release.