Smoking Cessation Drugs

Prescription and over-the-counter drugs can help you quit smoking, but e-cigarettes may not be the best option.

Nicotine is a powerfully addictive drug, and is the main reason it can be so hard to quit smoking and using other tobacco products.

If you want to quit but are struggling with the effects of nicotinewithdrawal, you may find it helpful to use a nicotine replacement product (so-called nicotine replacement therapy, or NRT) or a prescription drug that doesn't contain nicotine.

Prescription Drugs to Help You Quit Smoking

There are a variety of doctor-prescribed drugs that can help you quit smoking.

The drugs may be used along with some NRT products.

Speak with your doctor to find the best choice for you.

The options approved by the Food and Drug Administration (FDA) include:

Bupropion

Bupropion (Wellbutrin, Zyban, or Aplenzin) does not contain nicotine.

Instead, it is a prescription antidepressant that reduces symptoms of nicotine withdrawal by acting on chemicals in your brain that help trigger nicotine cravings.

For the best results, you should start taking bupropion one to two weeks before you quit smoking.

Your doctor may have you keep taking it for a few weeks after you fully quit smoking.

The usual dosage is one or two 150 milligram (mg) tablets per day.

This drug should not be taken if you have or have ever had:

• Seizures
• Heavy alcohol use
• Cirrhosis
• Serious head injury
• Bipolar disorder
• Anorexia or bulimia

The most common side effects of bupropion include:

• Dry mouth
• Trouble sleeping
• Tiredness
• Irritability
• Indigestion
• Headaches

Varenicline

Varenicline (Chantix) was developed specifically to help people stop smoking; it works by interfering with nicotine receptors in the brain.

The drug does this in two ways: it lessens the pleasure you get from smoking, and it reduces the symptoms of nicotine withdrawal.Varenicline should be started a week before you quit smoking.

Studies have shown that varenicline can more than double your chances of quitting smoking, and may be more effective than bupropion in the short term.

Varenicline is taken over a 12-week period at increasingly higher dosages.

Be aware that varenicline carries an FDA-required black-box warning because of use of the drug has been linked to depression, suicide ideation, and suicide.

People taking varenicline should be monitored for any kind of psychiatric symptoms, such as agitation, hostility, depressed mood, changes in behavior or thinking, or suicidal thoughts or behavior.

The most common side effects of varenicline include:

• Headaches
• Changes in taste
• Nausea
• Vomiting
• Trouble sleeping
• Gas

Other Stop-Smoking Drugs

Other prescription drugs, such as nortriptyline (Pamelor) and clonidine (Catapres), are sometimes recommended for smokers who cannot use varenicline or bupropion.

Both of these are older drugs that may have significant side effects.

Talk to your doctor to decide if either of these are a good option for you when you're ready to stop smoking

Nicotine Replacement Therapy (NRT)

The Food and Drug Administration (FDA) has approved five types of over-the-counter nicotine replacement therapy (NRT) products.

These include nicotine gum, patches, lozenges, and inhalers.

You can use more than one type at a time, but if you do, speak with your doctor to make sure you're not getting too much nicotine at once.

E-Cigarettes

Electroniccigarettes, or e-cigarettes, let you inhale nicotine without the smoke.

These electronic devices discharge a nicotine mist without some of the chemicals found in tobacco. They are among the most popular quit-smoking products on the market, but their use remains controversial among health experts.

Some doctors are concerned that e-cigarettes may be a "gateway drug" to tobacco products, and they contain several chemical compounds (such as formaldehyde) that can cause cancer. 

Additionally, e-cigarettes are not regulated by the FDA, so the health risks associated with their use are not fully understood.