The Plan: Step #2 – Using Medications

Medications and their different pros and cons, presented in a chart for easy reference

Patches deliver nicotine through the skin in different strengths, over different lengths of time.Pros:
Easy to use
Only needs to be applied once a day
Some available without a prescription
Few side effects

Cons:
Less flexible dosing
Slow onset of delivery
Mild skin rashes and irritationComments/limitations:Patches vary in strengths and the length of time over which nicotine is delivered. Depending on the brand you use, may be left on for anywhere from 16 to 24 hours. Some smokers who use these products can stop them abruptly, while others prefer to reduce their dosage slowly.

Nicotine Polacrilex (nicotine gum)

Nicorette®

The term "gum" is misleading. Although it actually is a gum-like substance impregnated with small amounts of nicotine, nicotine gum is not chewed like regular gum. Instead, you chew it briefly and then "park" it between your cheek and gum. The nicotine is absorbed through the lining of the mouth.

Pros:
Convenient
Flexible dosing
Faster delivery of nicotine than the patches

Cons:
May be inappropriate for people with dental problems and those with temporomandibular joint (TMJ) syndrome
Cannot eat or drink while the medication is in your mouth
Frequent use during the day required to obtain adequate nicotine levels

Comments/limitations:Many people use this medication incorrectly.Most of the time the gum is in your mouth, it should be "parked" between your cheek and gum. Read package directions carefully for a full explanation.

To achieve greatest benefit, you generally should chew nine or more pieces per day.

Nicotine Nasal Spray

Nicotrol® NS (prescription required)

Delivers nicotine through the lining of the nose when you squirt it directly into each nostril.

Pros:
Flexible dosing
Can be used in response to stress or urges to smoke
Fastest delivery of nicotine of currently available products
Reduces cravings within minutes

Cons:
Nose and eye irritation is common, but usually disappears within one week.
Frequent use during the day required to obtain adequate nicotine levels

Comments/limitations:Unlike nasal sprays used to relieve allergy symptoms, the nicotine spray is not meant to be sniffed. Rather, it is sprayed once into each nostril once or twice an hour. Take a deep breath, hold it, spray once into each nostril and exhale through the mouth.

Ask your pharmacist for help in using the product correctly.

Nicotine Inhaler

Nicotrol® Inhaler (prescription required)

A plastic cylinder containing a cartridge that delivers nicotine when you puff on it. Although similar in appearance to a cigarette, the inhaler delivers nicotine into the mouth, not the lung, and enters the body much more slowly than the nicotine in cigarettes.

Pros:
Flexible dosing
Mimics the hand-to-mouth behavior of smoking
Few side effects
Faster delivery of nicotine than the patches

Cons:
Frequent use during the day required to obtain adequate nicotine levels
May cause mouth or throat irritation

Comments/limitations:Puffing must be done frequently, far more often than your cigarette. Each cartridge lasts for 80 long puffs; each cartridge is designed for 20 minutes of use. A minimum of six cartridges per day is needed for three to six weeks, then the patient starts tapering off. You do not need to inhale deeply to achieve an effect. Small doses of nicotine provide a sensation in the back of the throat similar to cigarette smoke.

Non-nicotine medication

Zyban™ (bupropion hydrochloride)

Sustained-Release Tablets (prescription required)

Currently the only non-nicotine medication shown to be effective for quitting smoking. Treatment must be started at least one week before your target quit date.

Pros:
Easy to use
Pill form
Few side effects
Can be used in combination with nicotine patches

Cons:
Should not be used by patients with eating disorders, seizure disorders or those taking certain other medications
Lack of flexibility of useComments/limitations:This is the first medication to help quit smoking that is available in tablet form. Its primary role is to act on brain chemistry to bring about some of the same effects that nicotine has when people smoke. A small risk of seizure is associated with use of this medication. The main ingredient in Zyban has been available for many years as a treatment for depression under the trade name Wellbutrin. However, it works well in people with no depression as an aid to quit smoking.