Quit smoking basics (9)
- Chewing tobacco: Not a safe alternative to cigarettes
- Quit-smoking products: Boost your chance of quitting for good
- Quitting smoking: 10 ways to ride out tobacco cravings
- see all in Quit smoking basics
Quit-smoking action plan (7)
- Chantix: Stop-smoking medication to help you quit
- Smoking cessation: Creating a quit-smoking plan
- Quit smoking: Proven strategies to help you quit
- see all in Quit-smoking action plan
Living smoke-free (4)
- Staying smoke-free: How to avoid a smoking relapse
- Support groups: Make connections, get help
- Relaxation techniques: Learn ways to reduce your stress
- see all in Living smoke-free
Mayo Clinic Health Manager
Get free personalized health guidance for you and your family.
Get Started
About our e-newsletters
- Free e-newsletters
- Mayo Clinic expertise
- We do not share your e-mail address
Housecall, our weekly general-interest e-newsletter, keeps you up to date on a wide variety of health topics with timely, reliable, practical information, recipes, blogs, questions and answers with Mayo Clinic experts and more. Our biweekly topic-specific e-newsletters also include blogs, questions and answers with Mayo Clinic experts, and other useful information that will help you manage your health.
Housecall Archives
Mayo Clinic Housecall
Stay up to date on the latest health information.
What you get
- Free weekly e-newsletter
- Mayo Clinic expertise
- Recipes, tools and other helpful information
- We do not share your e-mail address
continued:
Quit-smoking products: Boost your chance of quitting for good
Nicotine nasal spray
Overview
The nicotine nasal spray delivers a solution into your nostrils that contains a small dose of nicotine. The nicotine enters your body by being absorbed through the lining of your nose. The recommended dose is a spray in each nostril one to three times an hour.
Pros
The nicotine nasal spray is short-acting, which means it can control sudden nicotine cravings and withdrawal symptoms for short periods of time. The nasal spray also works faster than does nicotine gum, lozenges and the inhaler. You control the dose by using the spray as needed throughout the day.
Cons
Nicotine nasal spray is available only by prescription. It may be inconvenient, since you must use the nasal spray repeatedly throughout the day to control cravings or withdrawal symptoms. Side effects include nasal, sinus and throat irritation, watery eyes, sneezing and coughing. These effects typically go away with regular use over five to seven days. The nasal spray also poses a slight risk of dependency.
Cautions
Nicotine nasal spray isn't recommended if you have a nasal or sinus condition.
Timeline
Nicotine nasal spray is often used for about three to six months. Recommended use is one to three sprays an hour at first, gradually tapering to none.
Bupropion SR (Zyban)
Overview
Bupropion is a prescription medication classified as a type of antidepressant. A sustained-release (SR) form of bupropion is approved for smoking cessation. Unlike nicotine replacement therapy, bupropion SR doesn't contain nicotine. It's thought to decrease tobacco cravings and withdrawal symptoms by increasing the levels of certain brain chemicals.
Pros
Bupropion SR is a pill, so it's relatively easy to use. It isn't considered addictive.
Cons
Bupropion SR is available only by prescription, including the brand name Zyban. Because it takes five to seven days to be effective, you typically must start taking bupropion SR a week or two before you quit smoking. Side effects may include insomnia, agitation, headache and dry mouth. Rarely, a severe allergic reaction or seizure can occur. Also, you must remember to take the pill every day.
Cautions
In July 2009, the Food and Drug Administration (FDA) required bupropion SR to carry a black box warning — the strongest safety warning that the FDA can issue about a prescription medication. The warning is required because bupropion SR may be associated with serious mental health problems either while taking it or after stopping it, including an increased risk of suicidal thoughts or behavior, hostility and depression. If you take bupropion SR, report any changes in mood or behavior to your doctor immediately and stop taking the medication. Bupropion SR isn't appropriate if you have a seizure or eating disorder, if you've lost consciousness for more than an hour because of head trauma, if you're already taking a medication containing bupropion, or if you take a type of antidepressant known as a monoamine oxidase inhibitor (MAOI).
Timeline
Bupropion SR is generally used for 12 weeks, but if you've successfully quit smoking, you can use it another six months to reduce the risk of a smoking relapse.
Varenicline (Chantix)
Overview
Varenicline is a prescription medication that can help reduce cravings for tobacco and control nicotine withdrawal symptoms. It also blocks nicotine receptors in your brain, which decreases the pleasurable effects of smoking.
Pros
Varenicline is a pill, so it's relatively easy to use. It isn't considered addictive.
Cons
Varenicline is available only by prescription, including the brand name Chantix. Some studies also have shown an increase in road accidents and falls among people taking varenicline. Other problems can include vision trouble, fainting, severe skin reactions, vivid or strange dreams, and impairment of the ability to drive or operate heavy machinery. Also, you must remember to take the pill every day.
Cautions
In July 2009, the FDA required varenicline to carry a black box warning — the strongest safety warning that the FDA can issue about a prescription medication. The warning is required because varenicline may be associated with serious mental health problems either while taking it or after stopping it, including an increased risk of suicidal thoughts or behavior, hostility and depression. If you take varenicline, report any changes in mood or behavior to your doctor immediately and stop taking the medication. Varenicline should be used with caution if you have severe kidney problems.
Timeline
Varenicline is typically used for 12 weeks, but if you've successfully quit smoking, you can use it another 12 weeks to reduce the risk of a smoking relapse.
Need more help to quit smoking?
The most effective strategy to quit smoking for good is to combine a quit-smoking product with a program that includes support from professionals trained to treat tobacco dependence. Consider joining a community stop-smoking group or starting in-person or telephone counseling. Call 800-QUIT-NOW (800-784-8669) to obtain free telephone counseling services and information about stop-smoking programs near you.
Previous page(2 of 2)
- Treating tobacco use and dependence: 2008 update. Rockville, Md.: U.S. Department of Health and Human Services. http://www.guideline.gov/summary/summary.aspx?doc_id=12520&nbr=6444&ss=6&xl=999. Accessed May 15, 2009.
- Stead LF, et al. Nicotine replacement therapy for smoking cessation (review). Cochrane Database of Systematic Reviews. 2009:CD000146.
- Nicotine patch fact sheet. Smokefree.gov. http://www.smokefree.gov/quit-smoking/medicationguide/nicotine_patch.html. Accessed May 13, 2009.
- Rennard SI, et al. Management of smoking cessation. http://www.uptodate.com/home/index.html. Accessed May 13, 2009.
- Public health alert: Important information on Chantix (varenicline). U.S. Food and Drug Administration. Accessed May 16, 2008.
- Ossip DJ, et al. Adverse effects with use nicotine replacement therapy among quitline clients. Nicotine & Tobacco Research. 2009;11:408.
- Nicotine gum fact sheet. Smokefree.gov. http://www.smokefree.gov/quit-smoking/medicationguide/nicotine_gum.html. Accessed May 13, 2009.
- Nicotine lozenges fact sheet. Smokefree.gov. http://www.smokefree.gov/quit-smoking/medicationguide/nicotine_lozenges.html. Accessed May 13, 2009.
- Nicotine inhaler fact sheet. Smokefree.gov. http://www.smokefree.gov/quit-smoking/medicationguide/nicotine_inhaler.html. Accessed May 13, 2009.
- Nicotine nasal spray fact sheet. Smokefree.gov. http://www.smokefree.gov/quit-smoking/medicationguide/nicotine_spray.html. Accessed May 13, 2009.
- Varenicline fact sheet. Smokefree.gov. http://www.smokefree.gov/quit-smoking/medicationguide/varenicline.html. Accessed May 13, 2009.
- Bupropion fact sheet. Smokefree.gov. http://www.smokefree.gov/quit-smoking/medicationguide/bupropion.html. Accessed May 13, 2009.
- Barbara Woodward Lips Patient Education Center. Medications to help you stop using tobacco. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2008.
- Hurt RD (expert opinion). Mayo Clinic, Rochester, Minn. May 26, 2009.
- FDA: Boxed warning on serious mental health events to be required for Chantix and Zyban. U.S. Food and Drug Administration. Accessed July 1, 2009.
