Smoking treatments

If you smoke, giving up is probably the greatest single step you can take to improve your health.

Information written and reviewed by Certified Doctors.

Contents

Treatment

If you smoke, giving up is probably the greatest single step you can take to improve your health.

Giving up smoking increases your chances of living a longer and healthier life. You'll start to notice the benefits soon after quitting. For example:

  • after one month your skin will be clearer, brighter and more hydrated
  • after three to nine months your breathing will have improved, and you will no longer have a cough or wheeze
  • after one year your risk of heart attack and heart disease will have fallen to about half that of a smoker

If you want to quit smoking, it's is a good idea to see your doctor.

Stop smoking help from your doctor

You'll be assessed to get an idea of your level of addiction and to outline the benefits of quitting. This is also a chance to identify potential triggers, such as if you live with others who smoke or you're under stress.

Your doctor can prescribe several different stop smoking treatments. The type prescribed will depend on your personal preference and whether you've used any before.

Nicotine replacement therapy (NRT)

Nicotine is highly addictive, and it's the nicotine in cigarettes that causes you to become addicted to smoking. Nicotine replacement therapy (NRT) works by releasing nicotine steadily into your bloodstream at much lower levels than in a cigarette, without the tar, carbon monoxide and other poisonous chemicals present in tobacco smoke.

This helps control your cravings for a cigarette that happen when your body starts to miss the nicotine from smoking.

NRT comes in different forms, including:

  • skin patches
  • chewing gum
  • inhalators, which look like plastic cigarettes through which nicotine is inhaled
  • tablets and lozenges, which you put under your tongue
  • nasal spray
  • mouth spray

Your doctor can prescribe NRT or you can buy it from a pharmacist.

There's no evidence that one particular type of NRT is more effective than another. The one you choose is down to personal preference.

When deciding, it helps to think about the type of smoker you are. For example, are you a heavy smoker who needs a cigarette as soon as you wake up, or are you an occasional smoker who only smokes when they are out having a drink, or after a meal?

Some heavy smokers find a 24-hour patch useful, as it helps to relieve the cigarette craving when waking up. Others prefer using an NRT nasal spray or mouth spray, because they're the fastest-acting form of NRT.

Some smokers find it useful to combine NRT products. For example, they wear patches through the day, then use gum or an inhalator to help relieve a sudden craving for a cigarette.

Most courses of NRT last eight to 12 weeks before you gradually reduce the dose and eventually stop. Most people stop using NRT altogether within three months, although heavy smokers may need to use it for longer.

Side effects of NRT include:

  • skin irritation when using patches
  • irritation of nose, throat or eyes when using a nasal spray
  • disturbed sleep, sometimes with vivid dreams
  • upset stomach
  • dizziness
  • headaches

Side effects are usually mild to moderate, but if they become particularly troublesome, contact your doctor as your dosage or type of NRT may need to be adjusted.

Also, the nasal spray can cause sneezing and watering eyes for a short time after use. So, don't use an NRT nasal spray while driving, or just before driving.

Nicotine replacement therapy and pregnancy

If you are pregnant or breastfeeding and you want to quit smoking, it's best to stop completely and immediately without any treatment.

However, if you feel you cannot stop smoking without help, your doctor may recommend NRT to control your cravings.

Nicotine is not good for your baby, but the greatest risk from smoking is posed by carbon monoxide, which can cause foetal hypoxia (a severe lack of oxygen). So although using NRT is not ideal for your baby, the risks of nicotine are far outweighed by the risks of continuing to smoke.

Read more about how to stop smoking during pregnancy.

Stop smoking medication

Zyban (bupropion)

Bupropion was originally designed to treat depression, but it was discovered that it also helped people quit smoking. It's not entirely clear why, but most experts believe it affects parts of the brain involved in addictive behaviour.

Bupropion is prescribed as one to two tablets a day.

You need to take bupropion for 7-14 days before you try to quit as the medication takes this long to reach its maximum effect. A course of treatment usually lasts seven to nine weeks.

Bupropion is not suitable for:

  • children and young people under 18
  • women who are pregnant or breastfeeding
  • people with anorexia or bulimia
  • people with a central nervous system tumour
  • people with severe cirrhosis of the liver

Bupropion can also increase your risk of having a seizure (fit), so it's not suitable for people who already have a higher-than-average risk of having seizures, such as people:

Bupropion can cause several side effects, including:

  • dry mouth
  • upset stomach
  • insomnia (trouble sleeping)
  • headaches
  • difficulty concentrating
  • dizziness
  • drowsiness

Champix (varenicline)

Varenicline is currently the only medication specifically designed to help you quit smoking.

It works by preventing nicotine from binding to receptors (parts of your brain that respond to nicotine), which eases cravings and reduces the rewarding and reinforcing effects of smoking.

If you've not stopped smoking completely before starting varenicline, aim to do so within 7-14 days of starting treatment. It's recommended you take varenicline for 12 weeks. If you successfully stop smoking in this time, you may be prescribed another 12 weeks of treatment to ensure you do not start smoking again.

Varenicline is not suitable for:

  • children and young people under 18
  • women who are pregnant or breastfeeding
  • people with epilepsy
  • people with advanced kidney disease

Side effects of varenicline include:

  • nausea and vomiting
  • headaches
  • insomnia (trouble sleeping)
  • unusual dreams
  • increased appetite
  • constipation or diarrhoea
  • swollen stomach
  • slow digestion
  • flatulence
  • dry mouth
  • tiredness
  • dizziness
  • drowsiness

There have been reports of people experiencing feelings of depression and suicidal thoughts after beginning treatment with varenicline.

While there's no evidence these symptoms are directly linked to the medication, if you feel depressed or have thoughts of suicide, stop taking varenicline immediately as a precaution, and contact your doctor.

Electronic cigarettes

Electronic cigarettes – or e-cigarettes – are electrical devices that mimic real cigarettes but using an electronic cigarette or ‘vaping’ as its come to be known, produces a vapour that’s potentially less harmful than tobacco smoke. Many e-cigarettes contain nicotine and, when they do, it’s the vapour that gives the nicotine hit.

Since their emergence around five years ago, e-cigarettes have become increasingly popular. They’re typically marketed as a healthier (and cheaper) alternative to traditional cigarettes. And, because they don’t smell or produce smoke, they may be used in places where smoking is banned, like bars, restaurants, public transport, planes and even hospitals (though it is courteous to get permission from those around you beforehand).

While e-cigarettes may be safer than conventional cigarettes, we don’t yet know the long-term effects of vaping on the body. There are other potential drawbacks to using them:

  • Electronic cigarettes aren’t currently regulated as medicines so you can’t be sure of their ingredients or how much nicotine they contain – whatever it says on the label
  • The amount of nicotine you get from an e-cigarette can change over time
  • They aren’t proven as safe. In fact, some e-cigarettes have been tested by local authority trading standards departments and been found to contain toxic chemicals, including some of the same cancer-causing agents produced from tobacco
  • So far, there’s no proof that they can help people to stop smoking

There are clinical trials in progress to test the quality, safety and effectiveness of e-cigarettes, but until these are complete, the government can’t give any advice on them or recommend their use.

Content supplied by NHS Choices