It is no secret that cigarette smoking is the #1 preventable cause of death. It is never too late to quit, as smokers who quit reduce their risk of tobacco-related diseases. Of course, stopping smoking can be difficult. However, there are effective medical treatments for tobacco dependence, and doctors at Medzino can help you with the available treatment options.
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Written by Dr Yasmin Aghajan, MD
Information last reviewed 06/21/19
Many people who smoke have thought about quitting in the past. There are 5 stages of “readiness to quit” and it is helpful to consider what stage you are in at this point in time.
From “Contemplation” to beyond, doctors can help provide medical treatments to help you achieve your quitting goal. Quitting begins with setting an “end date” and it is possible to successfully quit smoking with the guidance of your doctor.
Smoking cessation is not always easy, and there are several common barriers that patients experience.
Symptoms peak in the first three days of quitting, and can last up to three to four weeks. Smoking cessation medications can help with these symptoms.
Environmental Triggers: one obstacle to quitting smoking can be the environmental triggers associated with smoking, such as morning coffee, alcoholic drinks, or the end of a meal, or a break from work to take a walk.
Many smokers desire to quit, and using the available treatments gives them a better chance of being successful. The combination of behavior modifications, behavior counseling, and medications significantly improves the chance of success.
The first-line medications for smoking cessation include combination nicotine replacement therapy such as nicotine patch, gum, or lozenges with the addition of the medications Varenicline or Bupropion. It is important to go through a detailed medical history with your doctor before being prescribed one of these medications. More information is available through Medzino.
Varenicline and Bupropion are FDA-approved for smoking cessation, as they have shown to be effective in quitting smoking.
Medications are used in conjunction with nicotine replacement. Better results are seen with the combination of two nicotine replacement products, such as patch with gum or lozenge. The patch is long-acting, and gum or lozenge are short acting.
The FDA-approved medications are Varenicline and Bupropion, in conjunction with nicotine replacement products.
Cigarettes contain nicotine, and the body can get addicted to nicotine. Nicotine replacement are products such as gum, lozenges, and patches that provide a controlled amount of Nicotine to help curb the cravings while you are quitting.
Bupropion is a medication of the antidepressant class, which is also FDA approved for smoking cessation. It helps reduce the urge to smoke and withdrawal symptoms. It is a prescription-only medication. Treatment usually lasts 7-12 weeks, but may be longer. Bupropion is contraindicated in patients with a seizure disorder, or a history of seizures.
Varenicline is FDA approved for smoking cessation. It works by preventing nicotine stimulating the dopamine system in the brain which is associated with reward and nicotine addiction. It also helps with withdrawal and cravings.
Smoking is one of the leading causes of death, and is one of the biggest risk factors for lung cancer. Smoking raises the risk of heart disease. Cigarette smoke contains cancer-causing chemicals, called carcinogens. These chemicals travel from the lungs into the bloodstream, reaching all the organs in the body. Even secondhand smoke can be harmful, especially to children, infants, and those with asthma or respiratory disease.
Some people quit smoking without planning for it; others have to plan and try several times before success. There are some basic steps to start with:
Nicotine is addictive, and the withdrawal is one of the biggest barriers for patients to quit. Withdrawal symptoms include:
Symptoms peak in the first three days of quitting, and can last up to three to four weeks.
Nicotine reducing filters
Plastic filters that fit over the end of your cigarette, to reduce your intake of nicotine.
Reduces nicotine intake by 90-96%. Unknown how many people successfully quit smoking via this method.
No known side effects.
Patches that you stick on the skin, to give you nicotine without smoking. They are available in different strengths to help you reduce your nicotine intake.
7-9% effective at helping people to quit smoking. Up to 15% effective when used with other prescription medications.
It is important to read the instructions to identify the correct dosage, otherwise nicotine poisoning can occur.
Chewing gum form of nicotine replacement
A prescription medication that helps to reduce your brain’s response to nicotine. The dose decreases over time, to help you quit smoking.
Common side effects include:appetite changes, digestive disturbances, dry mouth, headache, nausea, weakness etc.
Contraindicated for conditions that may increase your likelihood of seizures.
A prescription medication that helps to reduce nicotine cravings and withdrawal symptoms. It can be used effectively alongside nicotine replacement therapies.
Common side effects include: anxiety, headache, nausea, pain etc.
Contraindicated for: alcoholism, diabetes, elderly, head trauma, predisposition to seizures.
Electronic cigarettes / vaping
Can be used in place of cigarette smoking or liquids with reducing nicotine content can be used as a nicotine replacement therapy.
18% of people successfully quit smoking when vaping and engaging with local stop smoking services. Vaping is thought to be less harmful than smoking cigarettes, however, the exact dangers and risks of vaping are still unknown, and they are not FDA approved for smoking cessation.
It is important to use reputable manufacturers for vaping products. Malfunctions or improper use can result in injuries.
Some people report benefits from herbal treatments, hypnotherapy, acupuncture and other alternative therapies.
The effectiveness of these treatments is not known.
The risks of these treatments may vary.
Disclaimer: This is not medical advice. You and your physician will determine if and how you should take any medication prescribed to you following a medical consultation.
Stead LF, Koilpillai P, Fanshawe TR, Lancaster T. Combined pharmacotherapy and behavioural interventions for smoking cessation. Cochrane Database Syst Rev 2016; 3:CD008286.
Rigotti NA. Strategies to help a smoker who is struggling to quit. JAMA 2012; 308:1573.
West R. Assessment of dependence and motivation to stop smoking. BMJ 2004; 328:338.
Siu AL, U.S. Preventive Services Task Force. Behavioral and pharmacotherapy interventions for tobacco smoking cessation in adults, including pregnant women: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2015; 163:622.
Quit Smoking, Smoking Cessation / Quitting Methods, https://quitsmoking.tech/ (accessed 20th July 2019)
NHS, Using e-cigarettes / vapes to quit smoking, https://www.nhs.uk/oneyou/for-your-body/quit-smoking/using-e-cigarettes-vapes-to-quit-smoking/ (accessed 20th July 2019)
Up to Date, E-cigarettes, Rigotti, 2019 (accessed 20th July 2019)
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