So, you have been trying to quit cigarettes using sheer willpower alone, and it's not working.
What do you do?
Kicking the life-shortening habit can be daunting, but there are smoking-cessation treatments that make it easier, such as nicotine replacement gums, patches and lozenges, along with prescription medications.
They all help with the hardest part of quitting: nicotine withdrawal. By the time smokers are desperate to stop, they are usually deeply hooked on nicotine. Nicotine withdrawal can make people angry, irritable, depressed, anxious and hungry, and it can also trigger problems with concentration and sleep. That's where patches, gums and lozenges that deliver small amounts of nicotine into the bloodstream can make a difference.
Nicotine gum or patches can ease withdrawal symptoms and double the chances of quitting, according to smokefree.gov.
Gums, patches and lozenges can be purchased over-the-counter, with patches delivering a steady stream of nicotine while gums and lozenges release nicotine as you chew or suck on them, according to the U.S. Centers for Disease Control and Prevention.
Nicotine gum is not used like regular gum. Chew it a few times and then park it between your cheek and the space below your teeth. The nicotine is absorbed mostly in your mouth. There are downsides to using the gum including its taste, stomach discomfort, excess saliva and feeling lightheaded, the CDC says.
Prescription nicotine replacement also comes in the form of an inhaler or nasal spray, the agency added.
Unfortunately, while nicotine replacement therapies can help ease withdrawal and cravings, it won’t erase the urge to smoke.
The best strategy is to combine nicotine replacement with other methods that can help you quit. These include counseling and the prescription drugs varenicline (Chantix) and bupropion (Wellbutrin/Zyban). Both drugs are approved by the U.S. Food and Drug Administration as treatments to help quit smoking.
Varenicline (Chantix)
Chantix is a pill that does not contain nicotine but rather acts by blocking receptors that react to nicotine, which helps reduce cravings, according to the U.S. National Library of Medicine.
The drug appears to be both fairly safe and effective. A recent study in the journal PLOS ONE found that when Chantix was combined with counseling it was more effective in getting smokers to quit than counseling alone.
Varenicline is not a benign drug, with side effects that include:
- nausea
- constipation
- diarrhea
- gas
- abdominal pain
- vomiting
- heartburn
- bad taste in the mouth
- dry mouth
- increased or decreased appetite
- toothache
- trouble falling asleep or staying asleep
- unusual dreams or nightmares
- headache
- lack of energy
- back, joint, or muscle pain
- abnormal menstrual cycles
Some side effects can be more serious, namely:
- swelling of the face, throat, tongue, lips, gums, eyes, neck, hands, arms, feet, ankles, or lower legs
- hoarseness
- difficulty swallowing or breathing
- rash
- swollen, red, peeling, or blistering skin
- blisters in the mouth
- pain, squeezing or pressure in the chest
- pain or discomfort in one or both arms, back, neck, jaw, or stomach
- shortness of breath
- sweating
- nausea, vomiting, or lightheadedness with chest pain
- slow or difficult speech
- sudden weakness or numbness of an arm or leg, especially on one side of the body
- calf pain while walking
- seizures
- sleepwalking
In clinical studies, those taking Chantix were more likely to have a heart attack, stroke or other serious problems with their heart or blood vessels.
Talk to your doctor about the risks and benefits of taking Chantix, especially if you have or ever had heart or blood vessel disease.
In 2021, Pfizer, the maker of Chantix, recalled the drug because of unacceptable levels of nitrosamine, a naturally occurring chemical that can cause cancer. But by the middle of 2022, the FDA announced that Chantix was safe to take as the levels of nitrosamine were now at acceptable levels.
Bupropion (Wellbutrin/Zyban)
Bupropion is an antidepressant that also can help people quit smoking. It's not clear exactly how the drug works, but it appears to reduce cravings for tobacco.
Bupropion can cause side effects, including:
- drowsiness
- anxiety
- excitement
- difficulty falling asleep or staying asleep
- dry mouth
- dizziness
- headache
- nausea
- vomiting
- stomach pain
- uncontrollable shaking of a part of the body
- loss of appetite
- weight loss
- constipation
- excessive sweating
- ringing in the ears
- changes in your sense of taste
- frequent urination
- sore throat
Serious side effects include:
- seizures
- confusion
- hallucinations
- irrational fears
- muscle or joint pain
- rapid, pounding or irregular heartbeat
Stop taking the drug and call your doctor if you experience:
- fever
- rash or blisters
- itching
- hives
- swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles or lower legs
- hoarseness
- difficulty breathing or swallowing
- chest pain
The best way to quit
While nicotine replacement and smoking-cessation drugs can help you quit, the best approach is to combine these with counseling or cognitive behavioral therapy or other self-help programs, including quit lines, phone apps and text reminders on quitting and quit plans, the CDC says.
