By Mayo Clinic staff
Quitting smoking is hard, but quit-smoking products can improve your odds of success. Know the options so you can choose the right quit-smoking product.
Want to quit smoking? Several quit-smoking products are available that can help you stop smoking for good. Using a quit-smoking product can greatly increase your chance of success. Only about 5 percent of people who try to quit tobacco succeed without a quit-smoking product. But more than 30 percent can succeed when using a quit-smoking product. You have the best chance at quitting smoking when you combine behavior therapy with use of one or more quit-smoking products.
Some quit-smoking products are known as nicotine replacement therapy because they contain small amounts of nicotine. Others are prescription medications without nicotine. Either type of quit-smoking product can help reduce nicotine cravings and withdrawal symptoms, making it more likely that you'll stop smoking for good.
Although you can buy some quit-smoking products without a prescription, it's best to consult your doctor before you try them. There's not a single best quit-smoking product for everyone. Together with your doctor, you can explore which quit-smoking products or combinations of products may be right for you, when to start taking them, and possible risks and side effects.
Nicotine Patch
Overview
The nicotine patch is a small, self-adhesive patch that releases a slow, steady amount of nicotine into your body through your skin. You apply a new nicotine patch every day on a hairless area of skin between your waist and neck, such as your upper arm or chest.
Pros
The nicotine patch is available without a prescription in various doses. The patch is easy to use. The nicotine patch is long acting, controlling nicotine cravings and withdrawal symptoms for 24 hours at a time. You can gradually taper off the nicotine patch as your cravings and withdrawal symptoms decrease.
Cons
You can't quickly adjust the amount of nicotine if you have sudden cravings or withdrawal symptoms. However, you may be able to use a second quit-smoking product along with the patch when a craving arises. The patch may cause skin itching, rash and irritation where it's applied. Patches also may cause sleep disturbances and vivid dreams. Removing the patch at night may help. Patches must be replaced every 24 hours. To minimize potential skin irritation, avoid putting the patch in the same place more than once every two weeks or so.
Cautions
If you have certain skin conditions, such as eczema or psoriasis, you may more easily develop skin irritation if you use the patch.
Timeline
It's typical to use the nicotine patch for eight to 12 weeks. You may need to use it longer if cravings or withdrawal symptoms continue.
Nicotine Gum
Overview
Nicotine gum contains a small amount of nicotine. The nicotine enters your body as it's absorbed through the lining of your mouth when you use the gum according to directions.
Pros
Nicotine gum is available without a prescription in two doses. It's short acting, which means it can control sudden nicotine cravings and withdrawal symptoms for short periods of time. When you first start using nicotine gum, you can use a piece every one to two hours, up to 24 pieces a day. Nicotine gum comes in several flavors. It's often used in combination with the nicotine patch and other quit-smoking products.
Cons
You must use nicotine gum repeatedly throughout the day to control cravings or withdrawal symptoms. Nicotine gum may only take the edge off cravings, not make them go away completely. You must follow a specific biting technique for nicotine gum to work effectively. Don't chew it like chewing gum. To release nicotine from the gum, bite a piece until it has a peppery taste or you notice a tingly sensation in your mouth. Then, to let the nicotine absorb, hold the gum between your gumline and cheek until the taste or tingly sensation stops. To release more nicotine, bite and hold again. Repeat the cycle for about 30 minutes, and then discard the gum because all the nicotine in it has been used. Side effects include jaw soreness from too much biting, as well as mouth irritation, nausea, stomach upset and excess saliva.
Cautions
Nicotine gum may stick to dentures or other dental work. Avoid eating or drinking anything but water for 15 minutes before use or during use to prevent problems with nicotine absorption.
Timeline
Nicotine gum is recommended for up to 12 weeks. You can start by using a piece every hour or two, and then gradually reduce the frequency as cravings and withdrawal symptoms decrease.
Nicotine Lozenge
Overview
Nicotine lozenges are tablets that contain a small amount of nicotine. The nicotine enters your bloodstream as it's absorbed through the lining of your mouth. You place a lozenge between your gumline and cheek and suck it slowly, allowing it to dissolve.
Pros
Nicotine lozenges are available without a prescription in different doses and flavors. Lozenges are short acting, which means they can control sudden nicotine cravings and withdrawal symptoms for short periods of time. You can use up to 20 lozenges a day. Nicotine lozenges are often used in combination with the nicotine patch and other quit-smoking products.
Cons
You must use nicotine lozenges repeatedly throughout the day to control cravings or withdrawal symptoms. Nicotine lozenges may sometimes cause nausea, indigestion, heartburn, throat irritation or hiccups.
Cautions
Nicotine lozenges may stick to dentures or other dental work. They're not meant to be chewed or swallowed whole. Avoid eating or drinking anything but water for 15 minutes before use or during use to prevent problems with nicotine absorption.
Timeline
Nicotine lozenges are recommended for about 12 weeks. Reduce how many times a day you use the lozenges as your cravings and withdrawal symptoms decrease.
Nicotine Inhaler
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 products.
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 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
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.
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