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decision pointShould I take medicine to quit smoking?

Quitting smoking is hard because your body becomes addicted to the nicotine in tobacco. Giving it up is more than just kicking a bad habit. Your body has to stop craving the nicotine. If you have decided to quit smoking, you may want to think about taking medicine that can make it easier to stop. You can also use this information if you want to quit using tobacco products such as chew or snuff, or if you smoke cigars or pipes.

Consider the following when making your decision:

  • Studies show that using medicines to quit smoking can double your chance of success. Because of that, experts recommend that all smokers take medicines to help when they try to quit.
  • The reason many people go back to smoking is because of nicotine withdrawal symptoms. Medicines can help relieve these symptoms.
  • Some insurance companies will pay for all or part of the cost of medicines used to quit smoking.
  • The medicines used most commonly to quit smoking have few side effects. Becoming addicted to the medicines is rare.
  • Quitting smoking can be stressful, and you may have to do more than just take medicine. Success also depends on getting ready, getting support, learning how to get along without tobacco, and being prepared for setbacks.

What are the medicines?

Your doctor may prescribe varenicline (Chantix) or bupropion (Zyban) to help you cope with cravings for tobacco. These medicines are pills and do not contain nicotine.

Varenicline acts on areas in the brain affected by nicotine. It helps with craving and withdrawal symptoms. Varenicline also blocks the effects of nicotine from tobacco. If you start smoking again while you are taking varenicline, the medicine lowers the sense of satisfaction you get from smoking, improving the chances that you will quit. Some studies have found that varenicline works better than bupropion.1 But how well one medicine works for others may be different from how well it works for you. You may need to try different medicines to find one that works for you.

You start taking varenicline about a week before you quit smoking, and you take it for a total of 12 to 24 weeks. You take varenicline 2 times a day, after meals.

The way bupropion helps people cope with cravings is not entirely known. Bupropion can help balance chemicals in your brain and reduce your withdrawal symptoms. Doctors also prescribe bupropion (under the brand name Wellbutrin) to treat depression. But it can help you stop smoking even if you do not have depression.

You start taking bupropion daily about 1 to 2 weeks before you quit smoking. This builds up the level of medicine in your body. You keep taking bupropion for 7 to 12 weeks after you stop using tobacco. You can take it for as long as 6 months to a year.

There are two other medicines you can try if varenicline and bupropion do not work or you cannot take them. These are nortriptyline (Aventyl, Pamelor) and clonidine (Catapres).

What are the risks of taking a medicine to quit smoking?

The most common side effects of varenicline include nausea, increased dreaming, and constipation. More people have side effects such as nausea, headache, and dizziness when they use both varenicline and a nicotine patch.

Varenicline may make current mental illness symptoms worse. Or it may bring back symptoms of mental illness in people who have had a mental illness such as depression or bipolar disorder.

Some people taking bupropion reported dry mouth and trouble sleeping. There is a small risk of having seizures when you use bupropion. The risk increases if you have had seizures in the past before you used bupropion.

Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. When you stop smoking, there may be a change in how other medicines work for you.

Using both medicine and professional counseling often works best to quit smoking. If you need more information on tips for quitting, see the topic Quitting Smoking.

Your choices are:

  • Take medicine your doctor prescribes to ease the symptoms of nicotine withdrawal.
  • Use over-the-counter nicotine replacement therapy.
  • Do not take any medicine.
  • Get counseling even if you do not take medicines.

The decision whether to take medicine to quit smoking takes into account your personal feelings and the medical facts.

Deciding about medicines to quit smoking
Reasons to take medicine to quit smoking Reasons not to take medicine to quit smoking
  • You smoke more than 10 cigarettes a day.
  • You have withdrawal symptoms-such as grouchy behavior, having trouble staying focused on what you're doing, or hunger-when you go too long without a cigarette.
  • You have tried to quit in the past without using medicine and started smoking again.

Are there other reasons you might want to take medicine?

  • You smoke fewer than 10 cigarettes a day.
  • You are younger than 18.
  • You are pregnant or breast-feeding.

Are there other reasons you might not want to take medicine?

These personal stories may help you make your decision.

Use this worksheet to help you make your decision. After completing it, you should have a better idea of how you feel about taking medicine to quit smoking. Discuss the worksheet with your doctor.

Circle the answer that best applies to you.

I'm ready to quit smoking.

Yes No Unsure

I've tried other ways to quit, and they didn't work.

Yes No NA*

I'm ready to ask my doctor about prescription and over-the-counter medicines.

Yes No Unsure

I think I need help with nicotine withdrawal symptoms, such as grouchy behavior and being nervous, hungry, or not staying focused on what I'm doing.

Yes No Unsure

I'm ready to find out about using support such as professional counseling.

Yes No Unsure

*NA=Not applicable

Use the following space to list any other important concerns you have about this decision.

 

 

 

 

 

What is your overall impression?

Your answers in the above worksheet are meant to give you a general idea of where you stand on this decision. You may have one overriding reason to use or not use medicine.

Check the box below that represents your overall impression about your decision.

Leaning toward using medicine to quit smoking

 

Leaning toward NOT using medicine to quit smoking

         

FDA Warning

The U.S. Food and Drug Administration (FDA) warns that people who are taking bupropion (Zyban) or varenicline (Chantix) and who experience any serious or unusual changes in mood or behavior or who feel like hurting themselves or someone else should stop taking the medicine and call a doctor right away.

Friends or family members who notice these changes in behavior in someone who is taking bupropion (Zyban) or varenicline (Chantix) for smoking cessation should tell the person their concerns and advise him or her to stop taking the drug and call a doctor right away.

Citations

  1. Varenicline (Chantix) for tobacco dependence (2006). Medical Letter on Drugs and Therapeutics, 48(1241/1242): 66–68.

Author Ralph Poore
Editor Marianne Flagg
Associate Editor Michele Cronen
Associate Editor Denele Ivins
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer John Hughes, MD - Psychiatry
Last Updated July 22, 2009

WebMD Medical Reference from Healthwise

Last Updated: July 22, 2009
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.

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