Quit Smoking: 7 Products to strike out nicotine

If you're a smoker, craving a cigarette with your morning coffee isn’t all in your mind. Smoking causes a real physical addiction that can be tough to shake.

Nicotine is the addictive ingredient in tobacco. Nicotine replacement therapy may help you curb cravings and wean you off tobacco. And that’s definitely something you want to do.

Tobacco use accounts for about one-third of all cancers. And 90% of lung cancer cases. It also contributes to heart disease, stroke and lung disease.

“Nicotine replacement therapy is a great place to start when you’re ready to stop using tobacco,” says Paul Cinciripini, Ph.D., director of MD Anderson’s Tobacco Treatment Program and professor in Behavioral Science. “It’s easy to use, has few side effects, and research shows it works for many people.”

If you’re a heavy smoker, medications also are available. “Pills prescribed by your doctor are very effective quitting tools,” says Maher Karam-Hage, M.D., associate medical director of MD Anderson’s Tobacco Treatment Program and associate professor in Behavioral Science.

So, to quit smoking once and for all, find out which product is right for you.

Medications to help you quit smoking

Your local drug store stocks several nicotine replacement products over the counter. These include patches, lozenges and gum. Other products, like pills, inhalers and nasal sprays, need a doctor’s prescription.

The patch: Once a day, you apply a small, latex patch on your upper body skin. It delivers a steady dose of nicotine. This makes it a good choice for heavy smokers.

Potential side effects:

• Skin rash
• Allergy
• Sleep problems or unusual dreams
• Racing heartbeat

Lozenges: Candy-like lozenges are great for a quick fix of nicotine. You place the lozenge in your mouth. It may take five to 10 minutes to feel the effect. Lozenges should dissolve within 30 minutes. Lozenges also may satisfy the need to keep your mouth busy so you’re not tempted to smoke. Potential side effects:

• Nausea
• Hiccups

Gum: Nicotine gum starts to work within five to 10 minutes — if you use it correctly. It comes in different flavors and two doses. Gum works only if you follow the instructions and use the proper dose. Potential side effects:

• Hiccups
• Nausea
• May stick to dentures

Inhalers: The inhaler is a plastic tube similar to the size and shape of a pen. When you take a puff, it instantly releases nicotine. It simulates the act of smoking. But you don’t inhale. Potential side effects:

• Coughing
• Throat irritation

Nasal spray: Nasal sprays are similar in size and shape to allergy or congestion nasal sprays. Yet, you shouldn’t inhale the spray in your sinus cavities. Instead, you let the spray sit in your nostril. Nasal sprays are easy to use. And they quickly send nicotine to your bloodstream. Nasal sprays work best for heavy smokers who get strong cravings. Potential side effects:

• Nasal irritation
• Runny nose and watery eyes
• Can harm children and pets

Chantix (Varenicline): Chantix (Varenicline) is a prescription medication taken as a pill, twice a day. It’s the most effective single product to help you quit smoking. And it doesn’t contain nicotine. It cuts cravings by acting like nicotine on the brain.

Chantix (Varenicline) binds to the nicotine receptors in your brain. It blocks the receptors, so smoking a cigarette won’t be as satisfying. It also triggers some of the same reward effects of nicotine. This helps reduce withdrawal symptoms and cravings. Potential side effects:

• Nausea
• Vivid dreams
• Intestinal gas   

Zyband (Bupropion): Zyband (Bupropion) is a prescription medication taken as a pill. Like Chantix (Varenicline), it doesn’t contain nicotine. It works by blocking nicotine receptors in your brain. Potential side effects:

• Insomnia
• Dry mouth
• Mild hand tremors

E-cigarettes aren’t effective quitting aids

No evidence exists to show that e-cigarettes are safe or that they can help you quit smoking. Yet, some people do use them and manage to quit.

“We don’t recommend using e-cigarettes as a strategy to help smokers quit,” Karam-Hage says. “Sooner or later, smoking them can bring a smoker back to cigarettes.”

Know your smoking behavior

Before you put on a patch or chew some gum, take a close look at your smoking habits.  

“I usually recommend people start with a patch and use gum or lozenges for intense cravings that the patch can’t handle,” Cinciripini says.

He also suggests:

• Trying another product if you’re not successful with the first one — or two.
• Trying combinations of products if you’re having intense cravings.

Fight cravings on all fronts

Whichever route you take:

• Talk to your doctor about your plans to quit. Especially if you’re considering medications, using more than one nicotine replacement product or have other health problems.  
• Get extra help. According to the National Cancer Institute, pairing nicotine replacement therapy with counseling sessions doubles your chances of success.
• Get free counseling by calling one of these quit lines:
  • The National Quitline: 1-800-QUIT NOW or text QUIT to 47848 to get smoke-free text messages.
  • National Cancer Institute: 1-877-44U-QUIT

Remember, quitting smoking offers significant health benefits — no matter how long you’ve been smoking. Within hours of kicking the habit your circulation improves. And within just weeks of quitting your lung function improves. Keep it up, and within one year you heart disease risk is 50% less.