Since the drugs don't put nicotine in your body—the way a patch or piece of nicotine gum does—many smokers continue to light up when they first start their prescription. Most patients also continue to take the drug for some time after they've quit for good.
When tested against placebos, these medications have been shown to significantly increase the likelihood of quitting. The one-year success rates reported in studies tend to range from 15% to 25%.
There are, however, side effects to consider—as with any medication. And even with help, your body may still have trouble adjusting to life without nicotine. Read the information below, and talk to your doctor, before trying any antismoking drug.
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.
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. Be sure to talk your doctor before using these products if you have a mental illness.
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.
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.
Compare your options
What is usually involved?
- You take pills or use nicotine replacement products, such as patches, gum, lozenges, or inhalers, as your doctor recommends.
- Your doctor can prescribe pills and inhalers. You can buy the other products without a prescription.
- You may also join a support group or have counseling to help you quit.
What are the benefits?
- You can double your chances of quitting smoking.
- The medicines can reduce your craving for tobacco and your nicotine withdrawal symptoms.
What are the risks and side effects?
- The medicine might not work to help you quit smoking.
- You could have side effects.
These depend on the type of medicine. Side effects may include:
- Nausea.
- Vivid dreams.
- Dry mouth.
- Trouble sleeping.
- Itching and redness where the patch is placed.
- Heartburn.
- Headaches.
- Cough.
What is usually involved?
- You could quit on your own
by:
- Stopping all at once ("cold turkey.")
- Cutting down slowly on the number of cigarettes you smoke.
- You may join a support group or have counseling to help you quit.
What are the benefits?
- You don't have the cost of medicines.
- You don't have possible side effects.
What are the risks and side effects?
- Quitting on your own might not work.
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.
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.
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:
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
What else do you need to make your decision?
Check the facts.
Using medicine can double my chances of quitting smoking.
- True You're right. Using medicine can double your chances of quitting smoking. It can relieve nicotine withdrawal symptoms.
- False Sorry, that's not right. Using medicine can double your chances of quitting smoking. It can relieve nicotine withdrawal symptoms.
- I'm not sure It may help to go back and read "How well do medicines work?" Using medicine can double your chances of quitting smoking. It can relieve nicotine withdrawal symptoms.
My chances of quitting are even better if I get counseling along with using medicine.
- True That's right. Counseling and medicine together can increase your chances of quitting even more.
- False No, that's not right. Counseling and medicine together can increase your chances of quitting even more.
- I'm not sure It may help to go back and read "How well do medicines work?" Counseling and medicine together can increase your chances of quitting even more.
I shouldn't use nicotine replacement products, because they're just as bad as the nicotine in cigarettes.
- True That's not right. Nicotine is addictive. But by itself, it's not nearly as harmful as smoking. Tars, carbon monoxide, and other toxic chemicals in tobacco cause the harmful effects.
- False You're right. Nicotine is addictive. But by itself, it's not nearly as harmful as smoking. Tars, carbon monoxide, and other toxic chemicals in tobacco cause the harmful effects.
- I'm not sure It may help to go back and read "What are the medicines?" Nicotine is addictive. But by itself, it's not nearly as harmful as smoking. Tars, carbon monoxide, and other toxic chemicals in tobacco cause the harmful effects.
Decide what's next.
Do you understand the options available to you?
Are you clear about which benefits and side effects matter most to you?
Do you have enough support and advice from others to make a choice?
Certainty.
How sure do you feel right now about your decision?
Check what you need to do before you make this decision.
- Nothing. I'm ready to take action.
- I want to discuss the options with others.
- I want to learn more about my options.
Use the following space to list questions, concerns, and next steps.
Personal Stories
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. It was great, because the withdrawal symptoms were hardly noticeable. I had to take the pills for 6 months, but they worked. 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
The first time I tried to quit, I went cold turkey. It only lasted a week. The next time I tried some kind of gum. This was in the '70s or '80s, so it was whatever kind of gum was available then, probably not the same as nicotine gum now. I quit smoking for a year that time, but I always craved cigarettes. The third time was right before I turned 60. I used Zyban and the nicotine patch for 6 weeks. I'm amazed at how well it worked. I have had no cravings for cigarettes, even from the very first day when I had my morning coffee. My father-in-law told me that, even 20 years after quitting, he still craved cigarettes every day, so that's what I was expecting. I didn't even throw away my cigarettes because I didn't expect it to work, but it worked incredibly well.
Roy, age 63
I started smoking at 13. I always thought I could quit at any time. But at 33 I was smoking a pack a day and had tried to quit dozens of times. I tried cold turkey. I was so grumpy I made a waiter cry. I tried hypnosis. It didn't work. I tried nicotine gum. It didn't work either. Finally, I tried the patch. I started with the largest one available. It was great because the withdrawal symptoms were hardly noticeable. Then I went to the medium patch and finally the smallest patch. I was really nervous about taking off that last patch. But I'd tapered off the nicotine so much that I had no withdrawal symptoms. That was nearly 12 years ago and I'm still smoke-free.
Nancy, age 46
Cigarettes were my best friend. They went on all my traveling adventures and they were there for me when I needed them, through heartbreaks, frustrations, and new jobs—20 years of companionship. I set a tentative date and started planning for the physical aspects of quitting, like having munchies around, cleaning my car and house. I bit the bullet and sent an e-mail out to all my friends and family, and I was floored by the support I got. A friend recommended acupuncture, so I made an appointment. For added incentive, I added daily exercise and a dog to my "new life." It has been 4 months and I am still a nonsmoker. I had daily cravings for the first 2 weeks, but now I go entire days without even thinking about cigarettes. If I ever start feeling on the edge, I will head right back to the acupuncturist for a tune-up!
Leta, age 35
I'm getting ready to quit smoking. I found that the massage I had to detoxify was amazing. My therapist combined the energy massage with detoxification, and when I left her office I had no desire to have a cigarette—unusual. After that I decided that acupuncture may help me, and I am taking those next steps, albeit baby steps. The homeopathic approach is the path I prefer to go down first, rather than through medications.
Robin, age 48
I quit smoking cold turkey 3 months ago. All my friends are really surprised that I quit. I mean, I would wake up every 2 hours at night to smoke a cigarette. People just identified me with smoking. I finally decided it was time to quit when I couldn't catch my breath walking up stairs. Other than gaining a few pounds, it really hasn't been bad.
Ian, age 52
References
Citations
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 (2003). Treatment Guidelines From the Medical Letter, 1(10): 65–68.
Last Updated: April 22, 2009 