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The Best Medication to Quit Smoking

by Wanda Lockwood

Overview

Smoking markedly increases your risks of respiratory and heart disease, but tobacco is highly addictive and quitting "cold turkey" can put you through withdrawal from nicotine, during which you may experience irritability, anxiety and cravings for tobacco. Most medical treatments for smoking cessation provide nicotine in a controlled manner in decreasing dosages so you can avoid severe withdrawal symptoms.

Stop Smoking
Over the Counter Drugs

You should not smoke during treatment with products that contain nicotine as this may increase your tobacco addiction rather than reducing it. Nicotine patches are available over the counter in different strengths. You should use them in decreasing dosages for a period of about eight weeks, usually starting with 21 mg per day for the first four weeks, then 14 mg per day and finally 7 mg per day for the last two weeks. If you feel the need to have something in your mouth--a common feeling among smokers--you may prefer nicotine lozenges or gum. You can chew 1 to 24 pieces of nicotine gum daily. The 2 mg dose is used for those who smoke fewer than 2 dozen cigarettes daily and the 4 mg dose for heavier smokers. Ideally, you will begin to decrease the number of pieces of gum you chew daily over the 12-week course of treatment. Nicotine lozenges also come in 2 and 4 mg and are used for 12 weeks, but you can only use up to 10 of 2 mg lozenges daily or 5 of the 4 mg. If you must have your first cigarette within a half hour of awakening, you may benefit more from the 4 mg lozenges.

Prescription Nicotine Products

Nicotine inhalers and nicotine nasal sprays are available only by prescription, and you may use them for up to 6 months. You can use the inhaler up to 16 times daily and can use the nasal spray up to 40 times daily, but both the inhaler and the spray may irritate the mucous membranes inside of mouth and nose. However, these are fast-acting because the nicotine enters the blood stream rapidly.
Prescription Drugs

Bupropion SR (Zyban) is an antidepressant that reduces tobacco cravings and withdrawal symptoms. You begin taking the medication two weeks before you stop smoking and take the drug for up to 12 weeks with maintenance for up to six months. Varenicline (Chantix) works in the brain to alter the sensation of pleasure associated with smoking. You will begin taking this drug about a week before stopping and then may continue the drug for 6 months or more. Both of these drugs can cause a wide range of symptoms, including nausea and vomiting, but more serious adverse effects include depression, personality changes, hostile behavior and suicidal thoughts. Because these drugs have been linked to suicides, an FDA advisory issued in July 2009 now requires that the manufacturers include a boxed warning about the dangers of taking these drugs. You should read these warnings carefully and share them with family and friends who can alert you if they see danger signs.