 Prescription drugs you can use to stop smoking include nicotine products and the oral drug bupropion (brand name Zyban). Nicotine replacement products and Zyban work best when used along with individual counseling or group support. To avoid side effects like raised blood pressure, nervousness, and rapid heartbeat, don't smoke while using nicotine products. Nicotine nasal spray (brand name >Nicotrol NS) and the nicotine oral inhaler (>Nicotrol Inhaler) help prevent or relieve symptoms of nicotine withdrawal. Some of these symptoms are anxiety, irritability, trouble concentrating, and nicotine craving. In studies, 20 to 30 percent of people who used nicotine nasal spray or the oral inhaler quit smoking. A recent study showed that the combination of a >nicotine patch and the nasal spray was more effective than either one alone in helping people to quit smoking. People typically use these products for three to six months after they quit. To avoid nicotine withdrawal when they stop using these products, some people need to cut back slowly over a period of several weeks to months. Zyban was the first non-nicotine drug proven to be effective for stopping smoking. It contains an antidepressant medicine that reduces cravings for nicotine. You may need to start taking this medicine for a week before you quit smoking. This gives the drug time to start working in your body. In studies, 44 percent of people who took Zyban quit smoking. The use of nicotine patches along with Zyban increased its success rate to 50 percent. People usually take Zyban for seven to 12 weeks. A new non- nicotine drug called varenicline (Chantix) was recently approved by the FDA and can help lessen the good feelings people get from smoking nicotine. It can also decrease the withdrawal symptoms that occur when quitting smoking. People usually take this medicine for 12 weeks followed by another 12 week course after quitting smoking. Over-the-counter nicotine products (patches, lozenge, and gum) are another option to help people quit smoking. Your choice of stop-smoking aids may be based on a variety of factors, including possible interactions with other medications, what products are covered by your health insurance, and what products have worked for you in the past. For help choosing the product that's right for you, talk to your doctor, pharmacist, or tobacco cessation counselor. Sources:
The AHCPR Smoking Cessation Clinical Practice Guideline, Journal of the American Medical Association 275 (1996).
Blondal T. “Nicotine Nasal Spray with Nicotine Patch for Smoking Cessation: Randomised Trial with 6 Year Follow Up,” British Medical Journal 318 (1999).
Jorenby DE. “A Controlled Trial of Sustained-Release Bupropion, A Nicotine Patch, or Both for Smoking Cessation,” The New England Journal of Medicine 340 (1999).
Kaye, L. "Pharmacologic and Behavioral Approaches to Smoking Cessation," Hospital Medicine 34 (1998).
Pharmacotherapy: A Pathophysiologic Approach. Appleton & Lange, 1999.
Diseases and Conditions, "Nicotine dependence."http://www.mayoclinic.com. Mayo Clinic Health. Last accessed 1/3/2007.
Drug Facts and Comparisons. Facts & Comparisons, 2007.
This answer prepared 5/16/2000.
This information updated 1/3/2007.
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