- Quit Tobacco Prescription | Smoking Cessation Drugs
- Varenicline (Chantix)
- Side effects of varenicline
- Using varenicline along with NRT or bupropion for quitting smoking
- Bupropion (Zyban)
- Side effects of bupropion
- Using bupropion along with NRT or varenicline for quitting smoking
- Other prescription drugs used to help people quit tobacco
- Other drugs being studied to help people quit tobacco
- Smoking — Medicines and Tips To Help You Quit
- Why Quit?
- Why is it so hard to quit?
- Nicotine Replacement Products
- Other Medicines to Help You Quit
- Quit Smoking Tips
- Resources For You
- Quitting Smoking for Older Adults
- Nicotine is a drug
- Help with quitting
- Breaking the addiction
- Cigars, pipes, hookahs, chewing tobacco, and snuff are not safe
- Secondhand smoke is dangerous
- Good news about quitting
- You can quit smoking: Stick with it!
- For more information about quitting smoking
Quit Tobacco Prescription | Smoking Cessation Drugs
There are prescription drugs that have been shown to help people quit tobacco. Some can be used along with nicotine replacement therapy (NRT). You often need to start taking them in the weeks before your Quit Day (the day you plan to quit).
People who are significantly dependent on nicotine should consider nicotine replacement and/or drug therapy to help them quit. Signs of severe nicotine dependence in people who smoke include:
- Smoking more than 1 pack a day
- Smoking within 5 minutes of waking up
- Smoking even while sick
- Waking up at night to smoke
- Smoking to ease symptoms of withdrawal
The more of these that apply, the more serious the dependence.
Talk to your health care provider if you think you might want to use one of these drugs to help you quit tobacco. You’ll need a prescription. It's also a good idea to talk to your health insurance about coverage for these medications.
If you plan to use a prescription drug to quit tobacco, talk with your health care provider about exactly when to start, and how to use the medicine. Also find out what side effects to watch for and report. Put a note on your calendar to remind you when to start taking it.
Varenicline (also called Chantix) is a prescription medicine developed to help people stop smoking. It works by interfering with nicotine receptors in the brain. This means it has 2 effects:
- It lessens the pleasure a person gets from smoking.
- It reduces the symptoms of nicotine withdrawal.
For people trying to quit smokeless tobacco, several studies have shown varenicline can increase their chance of quitting when compared to taking no medicines at all, at least in the short term. (Some studies have also found NRT lozenges can help.)
You typically start taking varenicline (a pill) about a month to a week before your Quit Day. Take it after meals, with a full glass of water. The daily dose increases over the first 8 days you take it. If you have problems with the higher doses, a lower dose may be used while you try to quit.
Typically, varenicline is given for 12 weeks, but people who quit during that time may get another 12 weeks of treatment to boost their chances of staying off tobacco. It’s important to keep up with other support systems during this time and for at least a few months after quitting.
Tell your provider about any medical conditions and allergies you have before you start varenicline, including if you might be pregnant.
Side effects of varenicline
Reported side effects have included:
- Trouble sleeping, unusual dreams, or sleepwalking
- Changes in taste
- Skin rashes
- Heart or blood vessel problems (mostly in people who already have these problems)
- Mood or behavior changes, such as depression, hallucinations, delusions, aggression, hostility, agitation, anxiety, panic, or even suicidal thoughts
Talk to your health care team about what to expect while taking this drug, and what to do if you or others notice possible side effects. Be sure to let your provider know if you’ve ever had depression or other mental health problems, or if you start feeling depressed or have thoughts about suicide.
Using varenicline along with NRT or bupropion for quitting smoking
Research is being done to find out if varenicline can be used at the same time as nicotine replacement therapy (NRT). A few studies have suggested that using varenicline along with NRT is well-tolerated and safe, but others have found this has no long-term benefit in helping people quit. More research is needed.
Research on using both varenicline and bupropion at the same time is also being done. While there may be a benefit to combining the drugs vs. taking only varenicline, more research is needed to understand if this could cause more severe side effects.
Bupropion also may be called by the brand names Zyban, Wellbutrin, or Aplenzin. It’s a prescription antidepressant in an extended-release form that helps reduce cravings and symptoms of nicotine withdrawal.
It does not contain nicotine. This drug acts on chemicals in the brain that are related to nicotine craving. Bupropion works best if it’s started 1 or 2 weeks before you quit smoking.
The usual dosage is one or two 150 mg tablets per day.
If you’re still not using tobacco after taking bupropion for 7 to 12 weeks, your provider may have you keep taking it for some time afterward to help stop you from going back to smoking. Keep up with your other support systems during this time and for at least a few months after you quit.
This drug should not be taken if you have or have ever had:
- Seizures (it can cause or worsen seizures)
- Heavy alcohol use
- A serious head injury
- Bipolar (manic-depressive) illness
- Anorexia or bulimia (eating disorders)
You also shouldn’t take it if you’re taking sedatives or have recently taken a monoamine oxidase inhibitor (MAOI, an older type of antidepressant).
Tell your doctor about any medical conditions and allergies you have before you start bupropion, including if you might be pregnant.
Side effects of bupropion
Reported side effects of bupropion include:
- Dry mouth
- Stuffy nose
- Trouble sleeping and nightmares
- High blood pressure
- Feeling depressed, anxious, agitated, hostile, aggressive, overly excited or hyperactive, or confused; or having suicidal thoughts
If you are using bupropion, call your health care provider if you feel depressed or start thinking of suicide. Also be sure to ask what to expect while taking this drug, and what to do if you or others notice possible side effects.
Bupropion can cause drug interactions and shouldn’t be used with certain other drugs or supplements. Be sure your provider knows about everything you take, such as prescription drugs, vitamins, herbs, supplements, and any medicines you take on your own when you need them, acetaminophen (Tylenol) or aspirin. Also be sure to tell every provider you see that you’re taking bupropion.
Using bupropion along with NRT or varenicline for quitting smoking
There is some consensus that using bupropion along with NRT might increase the odds of quitting. Research on using both varenicline and bupropion at the same time is also being done.
Other prescription drugs used to help people quit tobacco
For those who can’t use either of the US Food and Drug Administration (FDA)-approved drugs to help them quit, or for those who haven’t been able to quit using them, other drugs have shown promise in studies.
They’re recommended by the Agency for Healthcare Research and Quality for this kind of use, but have not been approved by the FDA for this purpose and so are used “off-label.” (See Off-label Drug Use for more on this.
) These drugs are only available with a prescription and are not recommended for pregnant women, teens, or people who smoke fewer than 10 cigarettes a day.
This is an older anti-depressant drug that helps reduce tobacco withdrawal symptoms. It has been found to increase chances of success in quitting smoking when compared to those taking no medicine. It’s typically started 10 to 28 days before a person stops smoking to allow it to reach a stable level in the body.
Some people have side effects a fast heart rate, blurred vision, trouble urinating, dry mouth, constipation, weight gain or loss, and low blood pressure when they stand up. The drug can affect a person’s ability to drive or operate machinery, and certain drugs cannot be used along with it.
If you and your health care provider decide to use this drug, be sure your provider and pharmacist know exactly what other drugs you’re taking before you start this medicine. Also be sure you know how to take it and how to taper off it when you are ready to stop.
The dose of nortriptyline must be slowly lowered, since the drug cannot be stopped suddenly without the risk of serious effects. People with heart disease should use this drug cautiously. Be sure to tell all your health care providers that you are taking this drug.
Clonidine is another older drug that has been shown to help people quit. It’s FDA-approved to treat high blood pressure. When used to quit smoking, it can be taken as a pill twice a day or worn as a skin patch that’s changed once a week.
If you’re planning to use this drug, be sure your health care provider and pharmacist know exactly what else you’re taking before you start taking it. The most common side effects of clonidine are constipation, dizziness, drowsiness, dry mouth, and unusual tiredness or weakness.
There are rarely more severe side effects, such as allergic reactions, a slow heart rate, and very high or very low blood pressure. Your health provider might want to watch your blood pressure while you are on this drug. The drug can affect your ability to drive or operate machinery.
You can start taking clonidine up to 3 days before you quit smoking, but it can also be started the day you quit. It shouldn’t be stopped suddenly. The dose must be lowered over a few days to prevent tremors, confusion, agitation, or a rapid increase in blood pressure.
Other drugs being studied to help people quit tobacco
A plant-based drug called cytisine has shown promise in other countries and is now being studied in the United States.
Naltrexone is a drug used to help those with alcohol and opioid abuse disorders. Studies are looking at ways to combine it with varenicline to help people quit smoking, especially people who smoke and are also heavy drinkers.
Also being tested are possible anti-smoking vaccines that are given as injections.
So far these new options seem to be safe, but their effect on smoking cessation has been disappointing.
Smoking — Medicines and Tips To Help You Quit
There are products that help wean your body off the nicotine you get from cigarettes and tobacco. There are other medicines that help you deal with the cravings and other problems that you feel when you stop smoking.
This page lists all of the different FDA-approved products you can use to help you quit. Talk to your doctor, nurse, or pharmacist about which product is right for you.
Quitting may improve your health and wellness. If you quit smoking, you may:
- lower your chance of dying of lung cancer
- improve your skin
- reduce bad breath
Some women also decide to quit for their children or family. Whatever your reasons for quitting, you have made the right choice.
Why is it so hard to quit?
Many people who smoke become addicted to the nicotine in cigarettes and other tobacco products. When you try to stop smoking, you might:
- crave cigarettes
- feel nervous
- feel irritable (cranky)
- have headaches
- have problems sleeping
- feel depressed
These may be signs of nicotine withdrawal. Talk to your health care provider about the medicines listed in this booklet that may help you deal with withdrawal.
Nicotine Replacement Products
Nicotine replacement products give your body nicotine without most of the other chemicals found in cigarettes and other kinds of tobacco. These products help you wean your body off tobacco and help you deal with withdrawal.
- Read the label and talk to your healthcare provider as needed about the right way to use each product.
- Ask how these products will affect your other medicines. Ask about the risks and side effects.
- Women who are pregnant or breastfeeding should only use nicotine replacement products if their doctor says that it is OK.
|Patch||Habitrol NicodermStore Brand or Generic||Over-the-Counter|
|Gum||Nicorette Store Brand or Generic||Over-the-Counter|
|Lozenge||Commit NicoretteStore Brand or Generic||Over-the-Counter|
You can get up-to-date facts about each product on the FDA website. Type in the brand name or generic name of your product at: Drugs@FDA.
Other Medicines to Help You Quit
Some prescription medicines have been found to help people deal with the withdrawal symptoms they feel when they quit smoking. Talk to your healthcare provider about the benefits, risks, and side effects for each medicine.
Other Things to Consider
Before you take Chantix or Zyban, tell your healthcare provider if you:
- are pregnant or plan to become pregnant.
- are breastfeeding.
When trying to quit smoking with or without stop-smoking medicines, some people have significant side effects including new or worsening mental health problems such as:
- thoughts about suicide or dying
- attempts to commit suicide
- new or worse depression
- new or worse anxiety
- feeling very agitated or restless
- panic attacks
- trouble sleeping (insomnia)
- new or worse irritability
- acting aggressive, being angry, or violent
- acting on dangerous impulses
- an extreme increase in activity and talking (mania)
- other unusual changes in behavior or mood
These symptoms happen more often in people who had a history of mental health problems before trying to quit smoking than in people without a history of mental health problems.
- Stop taking Chantix or Zyban and call your healthcare provider right away if you, your family, or your caregiver notices any of these side effects.
- Before taking these medicines, tell your healthcare provider if you have ever had depression or other mental health problems. You should also tell your provider about any symptoms you had during other times you tried to quit smoking.
- Read the patient Medication Guide that comes with each new Chantix or Zyban prescription because the information may have changed. The Medication Guide explains the risks associated with the use of the medicine.
Quit Smoking Tips
Quit Smoking… for yourself and for those who need you.
- Set a Quit Date
- Pick a day in the next 2 weeks.
- Plan fun activities for your quit day to take your mind off smoking and tobacco.
- Tell your Friends and Family
- Get help from the important people in your life.
- Join a support group.
- Call a quit smoking helpline.
- Plan for Challenges and Setbacks
- Plan ways to deal with cravings, withdrawal, and stress.
- Do not give up.
- Keep trying.
- Remove all Cigarettes and Other Tobacco
- Get rid of cigarettes and tobacco.
- Throw out your matches, lighters, and ashtrays.
- Clean your clothes and house to get rid of cigarette smell.
- Talk to your Healthcare Provider
- Talk to your doctor, nurse, or pharmacist about medicines to help you deal with nicotine withdrawal.
- Ask if your other medicines will work differently now that you have quit smoking.
Resources For You
Quitting Smoking for Older Adults
“I’ve smoked two packs of cigarettes a day for 40 years—what’s the use of quitting now? Will I even be able to quit after all this time?
It doesn’t matter how old you are or how long you’ve been smoking, quitting smoking at any time improves your health. When you quit, you are ly to add years to your life, breathe more easily, have more energy, and save money. You will also:
Research supported by the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), and the U.S. Food and Drug Administration (FDA) confirms that even if you’re 60 or older and have been smoking for decades, quitting will improve your health.
Smoking shortens your life. It causes about one of every five deaths in the United States each year. Smoking makes millions of Americans sick by causing:
- Lung disease. Smoking damages your lungs and airways, sometimes causing chronic bronchitis. It can also cause emphysema, which destroys your lungs, making it very hard for you to breathe.
- Heart disease. Smoking increases your risk of heart attack and stroke.
- Cancer. Smoking can lead to cancer of the lungs, mouth, larynx (voice box), esophagus, stomach, liver, pancreas, kidneys, bladder, and cervix.
- Respiratory problems. If you smoke, you are more ly than a nonsmoker to get the flu, pneumonia, or other infections that can interfere with your breathing.
- Osteoporosis. If you smoke, your chance of developing osteoporosis (weak bones) is greater.
- Eye diseases. Smoking increases the risk of eye diseases that can lead to vision loss and blindness, including cataracts and age-related macular degeneration (AMD).
- Diabetes. Smokers are more ly to develop type 2 diabetes than nonsmokers, and smoking makes it harder to control diabetes once you have it. Diabetes is a serious disease that can lead to blindness, heart disease, nerve disease, kidney failure, and amputations.
Smoking can also make muscles tire easily, make wounds harder to heal, increase the risk of erectile dysfunction in men, and make skin become dull and wrinkled.
Older adults are more ly to get severely ill from COVID-19. Smoking can make you more ly to be hospitalized, need the use of a ventilator to help you breathe, or need intensive care if you are affected by the COVID-19 virus. If you have any COVID-19 symptoms, it is important that you speak with your health care provider immediately. To learn ways to quit smoking, please visit the CDC.
Nicotine is a drug
Nicotine is the drug in tobacco that makes cigarettes so addictive. Although some people who give up smoking have no withdrawal symptoms, many people continue to have strong cravings for cigarettes. They also may feel grumpy, hungry, or tired. Some people have headaches, feel depressed, or have problems sleeping or concentrating. These symptoms fade over time.
Help with quitting
Many people say the first step to quitting smoking successfully is to make a firm decision to quit and pick a definite date to stop. Make a plan to deal with the situations that trigger your urge to smoke and to cope with cravings. You may need to try many approaches to find what works best for you. For example, you might:
Some people worry about gaining weight if they quit. If that concerns you, make a plan to exercise and be physically active when you quit—it may distract you from your cravings and is important for healthy aging.
Breaking the addiction
When you quit smoking, you may need support to cope with your body’s desire for nicotine. Nicotine replacement products help some smokers quit. You can buy gum, patches, or lozenges over the counter.
There are also prescription medications that may help you quit. A nicotine nasal spray or inhaler can reduce withdrawal symptoms and make it easier for you to quit smoking.
Other drugs may also help with withdrawal symptoms. Talk with your doctor about which medicines might be best for you.
Cigars, pipes, hookahs, chewing tobacco, and snuff are not safe
Some people think smokeless tobacco (chewing tobacco and snuff), pipes, and cigars are safe alternatives to cigarettes. They are not. Smokeless tobacco causes cancer of the mouth and pancreas. It also causes precancerous lesions (known as oral leukoplakia), gum problems, and nicotine addiction.
Pipe and cigar smokers may develop cancer of the mouth, lip, larynx, esophagus, and bladder. Those who inhale when smoking are also at increased risk of getting lung cancer as well as heart disease, chronic bronchitis, chronic obstructive pulmonary disease, and emphysema.
Using a hookah to smoke tobacco poses many of the same health risks as cigarette smoking.
Secondhand smoke is dangerous
Secondhand smoke created by cigarettes, cigars, and pipes can cause serious health problems for family, friends, and even pets of smokers. Secondhand smoke is especially dangerous for people who already have lung or heart disease.
In adults, secondhand smoke can cause heart disease and lung cancer. In babies, it can increase the risk of sudden infant death syndrome (SIDS), which is the unexplained death of a baby younger than 1 year of age.
Children are also more ly to have lung problems, ear infections, and severe asthma if they are around secondhand smoke.
Electronic cigarettes, or e-cigarettes, deliver nicotine, flavor, and other chemicals that are inhaled by the user. They are sometimes called “e-cigs,” “e-hookahs,” “mods,” “vape pens,” “vapes,” or “tank systems,” and may look regular cigarettes, pens, or even USB sticks.
They may contain harmful substances lead and cancer-causing chemicals, in addition to nicotine, which is addictive. Some flavorings in e-cigarettes have been linked to lung disease. Scientists are still studying the long-term effects e-cigarettes may have on your health. The U.S.
Food and Drug Administration (FDA) has not approved e-cigarettes as a quit-smoking aid. There is limited evidence that they help smokers quit.
Good news about quitting
The good news is that after you quit smoking, even in your 60s, 70s, or beyond:
- Your heart rate and blood pressure drop to more normal levels.
- Your nerve endings begin to regenerate, so you can smell and taste better.
- Your lungs, heart, and circulatory system will begin to function better.
- You will cough and feel breath less often.
- Your chance of having a heart attack or stroke will drop.
- Your breathing will improve.
- Your chance of getting cancer will be lower.
No matter how old you are, all these health benefits are important reasons to make a plan to stop smoking.
A trained counselor can help you stop smoking or stay on track. You can call:
You can quit smoking: Stick with it!
Many people need a few tries before they quit smoking for good. If you slip and have a cigarette, you are not a failure. You can try again and be successful. Try these tips to get back to your goal.
It’s never too late to get benefits from quitting smoking. Quitting, even in later life, can significantly lower your risk of heart disease, stroke, and cancer over time and reduce your risk of death.
Read about this topic in Spanish. Lea sobre este tema en español.
For more information about quitting smoking