Medications to help you quit smoking

Cigarette smoking is associated with a wide range of health risks, and experts advise avoiding it altogether or quitting if you already smoke. However, smoking is very addictive, which means quitting is often very difficult. You may need extra support.

The Food and Drug Administration (FDA) has approved several medications to help you quit smoking. These may work by replacing nicotine or by affecting your brain and making you less likely to want to smoke. If you think you need help with quitting smoking, consider speaking with a doctor.

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Prescription medications to quit smoking

When you’ve been smoking for a while and then abruptly stop, you’re likely to experience withdrawal symptoms and severe cravings, which can make quitting very difficult. Common withdrawal symptoms include:

• irritability
• restlessness
• difficulty concentrating
• trouble sleeping
• anxiety
• weight gain

The FDA has approved two prescription medications to help you quit smoking. These are varenicline (Apo-varenicline) and bupropion (Zyban).

Varenicline

Varenicline is a prescription-only medication to help you quit smoking that does not contain nicotine. It works by mimicking some of the effects of nicotine on your brain, which can reduce cravings and some withdrawal symptoms. It can also reduce the enjoyment you get from cigarettes.

Varenicline is available as 0.5 milligram (mg) and 1 mg oral tablets. You should start taking varenicline around 1 week before you stop smoking. The dosing regimen is usually 0.5 mg once per day for 3 days, increasing to twice per day until day 7. Then, take 1 mg twice per day for the duration of your treatment.

Treatment can last longer than 6 months.

Varenicline may cause some side effects, including:

• nausea
• insomnia
• headaches
• strange dreams

Bupropion

Doctors usually prescribe bupropion as an antidepressant, but it is FDA approved to help you quit smoking. It works by affecting how your brain responds to certain neurotransmitters released when you smoke, such as dopamine and serotonin. It can reduce cravings and withdrawal symptoms.

Like with varenicline, you should start bupropion 1 week before quitting smoking. The starting dose is 150 mg once per day for 3 days. Then, it is increased to 150 mg twice per day for 7 to 12 weeks.

The side effects of bupropion include:

• nausea
• dizziness
• difficulty sleeping
• constipation

Combination therapy

In some cases, like if you’re a very heavy smoker, doctors might recommend using both varenicline and bupropion. Some 2019 evidence suggests that combined therapy can improve the rate at which people abstain from smoking after 6 months of treatment. However, the risk of side effects like anxiety and insomnia also increases.

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Nicotine replacement therapy

Nicotine replacement therapy (NRT), true to its name, involves using medications that contain controlled amounts of nicotine to replace the nicotine the body craves from smoking. This is generally a safer source of nicotine than cigarettes, which also contain other harmful chemicals.

NRT products usually contain lower amounts of nicotine than cigarettes, and evidence suggests it can increase the chances of quitting by up to 70%. Unlike smoking, these medications do not cause cancer, lung disease, or heart disease.

According to the Centers for Disease Control and Prevention (CDC), NRT is much less addictive than cigarettes because the nicotine takes less time to get to your brain. It can help you get used to having less nicotine in your system. It can also reduce the uncomfortable symptoms of nicotine withdrawal.

Many NRT medications are available over the counter (OTC), and they come in various forms, including:

• patches
• lozenges
• inhalers
• gum
• sprays

NRT usually lasts for around 6 to 12 weeks. The dosage you should take depends on different factors, including your weight and how many cigarettes you’d usually smoke per day.

Like any medication, NRT products may cause some side effects, including:

• abdominal pain
• nausea and vomiting
• headache
• heart palpitations
• indigestion

Other strategies to help you quit

According to some 2021 research, adherence rates to NRT are quite low in the general population despite there being a strong link between adherence and success in quitting smoking. Some other strategies may help support you along the way.

For example, behavioral therapy, including techniques used in cognitive behavioral therapy (CBT), can help to alter your behaviors and improve your self-control. You can also implement goal-setting and reward techniques to help you resist the urge to smoke.

According to a 2024 review, a combination of behavioral therapy and medications is the most common approach for quitting smoking, and combining therapies is usually more effective than only trying one method.

Online care for quitting smoking

Smoking is associated with a wide range of health risks, including forms of cancer, stroke, lung disease, and heart disease. It’s important to quit as soon as possible to reduce these risks.

Online care services, including Optum Perks Online Care, may make getting treatment easier. With these services, you can submit an online form answering a few questions about your symptoms, and a US-licensed healthcare professional will respond soon after to prescribe a treatment plan.

Summary

Quitting smoking can be a very difficult process, coming with intense cravings and sometimes severe withdrawal effects. Certain medications may help make the process easier.

Two prescription medications can help you quit smoking: varenicline and bupropion. These both affect your brain in different ways, reducing cravings and withdrawal symptoms. Nicotine replacement therapies may also help, which are available OTC and come in different forms, like patches or gum.

Doctors generally also recommend some lifestyle strategies to help, including behavioral therapy and strategies like goal-setting. Combined with medications, these can be very beneficial in helping you quit smoking for good.

Download the free Optum Perks Discount Card to save up to 80% on many prescription medications. Plus, you can now get them delivered to your home in as little as 3 days. Search for your medication here.