Quitting Smoking: Should I Use Medicine?

Quitting Smoking: Should I Use Medicine?
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Get the facts
Compare your options
What matters most to you?
Where are you leaning now?
What else do you need to make your decision?

1. Get the facts

Your options

Use medicine to help you quit smoking. This may include nicotine replacement products.
Don't use medicine or nicotine replacement products to help you quit smoking.

Key points to remember

Using medicines and nicotine replacement products (patches, gum, lozenges, nasal spray, and inhalers) can increase your chances of quitting smoking. They can relieve nicotine craving and withdrawal symptoms.
Getting counseling along with using medicine or nicotine replacement products can raise your chances of quitting even more.
Nicotine replacement products may cause some side effects, such as problems with sleep or red and itchy skin with the patch. Medicines in pill form can cause nausea, dry mouth, and trouble sleeping.
Nicotine replacement products 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.
Some insurance companies may pay for all or part of the cost of quit-smoking medicines.

FAQs

What are the medicines?

Your doctor may prescribe varenicline (Chantix) or bupropion SR 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 take it 2 times a day, after meals. You can also take varenicline for 12 more weeks than the other methods for a total of 24 weeks. There are three ways to quit smoking when you take varenicline. These methods are:
- Fixed: You will stop smoking after you have taken varenicline for one week.
- Flexible: You can pick a date to quit smoking between 8 and 35 days after you start taking varenicline.
- Gradual: You cut your smoking in half every 4 weeks until you quit at the end of 12 weeks, or sooner.
Bupropion SR can help balance chemicals in your brain to reduce your withdrawal symptoms. You start taking bupropion daily about 1 to 2 weeks before you quit smoking. You keep taking it for 7 to 12 weeks after you stop smoking.

Nicotine replacement products

Nicotine replacement products give your body some nicotine to help reduce withdrawal symptoms and cravings. Nicotine is addictive. But these products have less nicotine than cigarettes. 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 products:

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.
Nasal spray releases a mist that contains nicotine.

You can buy nicotine gum, patches, and lozenges without a prescription. You need a prescription to buy inhalers and nasal spray. 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 combine nicotine replacement products. 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.

If you have a health condition, such as mental illness or heart problems, or if you take medicine for a mental health condition, be sure to talk to your doctor before you use nicotine replacement products.

How well do medicines work?

Medicines and nicotine replacement products can increase your chances of quitting.^{1, 2}

Getting counseling along with using medicine or nicotine replacement products can raise your chances of quitting even more.³

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.
Trouble sleeping.

Some people also have side effects such as headaches and dizziness.

Chantix may be linked with a small risk of heart attack or stroke in people with heart disease. Talk with your doctor about the possible benefits and risks for you.

Some people who take bupropion SR 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 a few hours before you go to sleep usually helps 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, 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.
Nicotine nasal spray can cause a burning or itchy feeling in your nose and throat, sneezing, and watery eyes.

Why might your doctor recommend that you use medicine?

Your doctor might recommend that you use medicine or nicotine replacement products to stop smoking if:^{4, 2}

You want to quit smoking.
You have tried on your own to stop smoking but you weren't able to stop.

2. Compare your options

	Use medicines to quit smoking	Don't use medicines
	What is usually involved? You take pills or use nicotine replacement products, such as patches, gum, lozenges, nasal sprays, or inhalers, as your doctor recommends. Your doctor can prescribe pills, inhalers, and nasal sprays. You can buy the other products without a prescription. You may also join a support group or have counseling to help you quit.	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 can increase your chances of quitting smoking. The medicines can reduce your craving for tobacco and your nicotine withdrawal symptoms.	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? 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 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.

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 a medicine. He also recommended that I have counseling and join a support group. It's been a little over a month since I started the medicine, 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 a medicine and nicotine gum. It was great, because between the pills and the gum, the withdrawal symptoms were hardly noticeable. I was done with the gum after the first few weeks, but I ended up staying on the pills for 6 months. But using both worked for me, and 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

3. 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.

More important

Equally important

More important

I'm not concerned about possible side effects.

I am very concerned about side effects.

More important

Equally important

More important

I'm not worried about how I will pay for the medicine.

I'm worried about how I will pay for the medicine.

More important

Equally important

More important

My other important reasons:

More important

Equally important

More important

4. 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

Leaning toward

Undecided

Leaning toward

5. What else do you need to make your decision?

Check the facts

1. Using medicine or nicotine replacement products can increase my chances of quitting smoking.

True
False
I'm not sure

You're right. Using medicine or nicotine replacement products can increase your chances of quitting smoking.

2. My chances of quitting are even better if I get counseling along with using medicine or nicotine replacement products.

True
False
I'm not sure

That's right. Getting counseling along with using medicine or nicotine replacement products can raise your chances of quitting even more.

3. I shouldn't use nicotine replacement products, because they're just as bad as the nicotine in cigarettes.

True
False
I'm not sure

You're right. Nicotine replacement products have less nicotine than cigarettes. By itself, nicotine is not nearly as harmful as smoking. Tars, carbon monoxide, and other toxic chemicals in tobacco cause the harmful effects.

Decide what's next

1. Do you understand the options available to you?

2. Are you clear about which benefits and side effects matter most to you?

3. Do you have enough support and advice from others to make a choice?

Certainty

1. How sure do you feel right now about your decision?

Not sure at all

Somewhat sure

Very sure

2. Check what you need to do before you make this decision.

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.

Credits and References

Credits

By	Healthwise Staff
Primary Medical Reviewer	Adam Husney MD - Family Medicine
Primary Medical Reviewer	Elizabeth T. Russo MD - Internal Medicine
Primary Medical Reviewer	Kathleen Romito MD - Family Medicine
Primary Medical Reviewer	John Hughes MD - Psychiatry
Primary Medical Reviewer	Andrew Littlefield PhD - Psychology, Behavioral Health

References

Citations

Hartmann-Boyce J, et al. (2018). Nicotine replacement therapy versus control for smoking cessation. Cochrane Database of Systematic Reviews, (5). DOI: 10.1002/14651858.CD000146.pub5. Accessed October 31, 2022.
Leone FT, et al. (2020). Initiating pharmacologic treatment in tobacco-dependent adults. an official American Thoracic Society clinical practice guideline. American Journal of Respiratory and Critical Care Medicine, 202(2): e5–e31. DOI: 10.1164/rccm.202005-1982ST. Accessed October 31, 2022.
Stead LF, et al. (2016). Combined pharmacotherapy and behavioural interventions for smoking cessation. Cochrane Database of Systematic Reviews, (3). DOI: 10.1002/14651858.CD008286.pub3. Accessed October 31, 2022.
U.S. Department of Health and Human Services (2020). Smoking cessation: A report of the Surgeon General. U.S. Department of Health and Human Services. https://www.hhs.gov/sites/default/files/2020-cessation-sgr-full-report.pdf. Accessed October 31, 2022.