Medicine Basics for Smokers

Description: 
Nicotine Replacement Therapies (NRTs), when used with the behavior-related information on the other pages of this website, can help you increase your changes of quitting smoking permanently.

Pills in a person's hand

What Kinds of Medicines or Other Treatments Will Help Me Remain Smoke-Free?

Nicotine replacement therapies (NRTs), when used with the behavior-related information on the other pages of this website, can help you increase your chances of quitting smoking permanently.

An NRT helps you deal with the physical addiction, and seeking help from a tobacco cessation counselor helps you deal with the psychological addiction and can provide a supportive atmosphere (see our counseling resources handout). In fact, using a combination of NRT and attending a smoking cessation class is more effective at helping you quit long-term than doing either one alone. People who have outside help, such as attending support groups or smoking cessation programs, and who get advice from their doctor to quit smoking have quit rates as high as 35%.

This section focuses on the different treatments available. Not all therapies work for all people, and certain groups of people, such as pregnant women and people with high blood pressure, should avoid some therapies.
Be sure to talk with your doctor about these medications.

Recommended First-Line Therapies

Note: if your doctor recommends that you use an NRT listed below (inhaler, gum, lozenge, spray, or patch), be sure you learn HOW to use it correctly. Your doctor can show you how to you use it properly. One reason why NRTs don't work for some people is because people don't use them exactly as they are supposed to be used.

  • Bupropion hydrochloride SR (Zyban®)
  • Varenicline (Chantix®)
  • Nicotine inhaler
  • Nicotine gum
  • Nicotine nasal spray

  • Nicotine patch
  • Nicotine lozenge

Second-Line Therapies

  • Nortriptyline

Additional Information

  • Summary of medications

    Over-the-Counter Medications

    Type

    Name Schedule Cost Estimate


    (typical online prices January 2007)
    Comments

    Nicotine Patch

    Habitrol®

    (8 - 12 weeks)

    21 mg for 6 weeks, then 14 mg for 2 weeks, then 7 mg for final 2 weeks

    7 mg box: $37; 14 mg box: $47; 21 mg box: $48

    The 21-mg patch equals less than three-fourths of a pack of cigarettes per day

    Nicoderm CQ®

    Nicotrol®

    15 mg for 6 weeks

    Nicotine Gum

    Nicorette®

    (4 - 6 months)


    2 mg nicotine per piece; take 9 to 12 pieces a day

    box of 100-170 2 mg pieces: $48; box of 100-110 4 mg pieces: $63

    Each piece releases about half of its nicotine

    Nicorette DS®

    (4 - 6 months)


    4 mg nicotine per piece; take 9 to 12 pieces a day

    Nicotine Lozenge Commit® box of 72, 2 mg lozenges: $34;
    box of 72, 4 mg lozenges: $39

    Prescription Medications

    Type Name

    Schedule Cost Estimate Comments

    Nicotine Nasal Spray

    Nicotrol NS®

    (3 - 6 months)

    1 - 2 doses/hr

    2 sprays = 1 mg

    $49 per bottle

    Not appropriate for patients with nasal or sinus problems, allergies, or asthma

    Nicotine Inhaler

    Nicotrol® Inhaler

    (8 - 12 weeks)

    6 - 16 cartridges/day

    box of 168, 10mg cartridges: $196

    May satisfy oral fixation associated with smoking

    Bupropion

    Wellbutrin®, Zyban®

    (2 - 3 months)

    150 mg each AM for 3 days, then twice a day with second dose in the PM

    $97/month (generic)

    Helps control withdrawal symptoms

    Varenicline

    Chantix®

    12 weeks

    0.5 mg each AM for 3 days, then 0.5 mg twice a day with second dose in the PM for 4 days, then 1 mg twice daily

    $131/month

    Helps control reduce nicotine craving and withdrawal.

    (Cost information adapted from Fiore, et al., 2008)

  • Quit-smoking treatments comparison

    Below is a table that shows estimated abstinence rates of different smoking cessation treatments.

    Drug Estimated abstinence

    rate (95% CI)

    Varenicline (Chantix®) (2mg/day) 33.2 (28.9-37.8)
    Varenicline (Chantix) (1mg/day) 25.4 (19.6-32.2)
    Nicotine Nasal Spray 26.7 (21.5-32.7)
    Nicotine Patch High Dose (>24mg) 26.5 (21.3-32.5)
    Nicotine Patch (6-14 weeks) 23.4 (21.3-25.8)
    Long-Term Nicotine Patch (> 14
    weeks)
    23.7 (21.0-6.6)
    Nicotine Gum (long term > 14 wks) 26.1 (19.7-33.6)
    Nicotine Gum (6-14 weeks) 19.0 (16.5-21.9)
    Nicotine Inhaler 24.8 (19.1-31.6)
    Bupropion SR (Zyban®) 24.2 (22.2-26.4)

    (Source: Fiore et al, 2008)

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