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Stop Smoking Drugs – FAQ

Stop smoking medications are primarily available as nicotine replacement therapy (transdermal patch and gum) and the pill bupropion (Zyban). Unless there are good reasons to not use these medications, anyone quitting smoking should strongly consider using them to reduce craving intensity and nicotine withdrawal side effects. Always discuss your intentions with your doctor or pharmacist before taking any medication.

Isn’t using a nicotine patch or the gum a crutch? I am addicted to nicotine, why would I want to take it another form?

A common statement made by people is that they do not want to use another crutch to control cravings. To them, it seems they are substituting another substance for smoking. I advise them as follows:

1) Using a medication may double your chances of quitting one of the hardest addictions to overcome in the world.
2) The use of medications is temporary and is combined with thinking and behavioral counseling to support both the physical and psycho- logical aspects of your habit.
3) The cigarette is the most effective drug delivery device in the world. The nicotine from a cigarette enters your brain within seconds after a puff. This in part leads to the powerful addiction you developed to nicotine. The smoking medications we use do not provide the same quick rush of nicotine or chemicals to your brain & therefore are not really comparable to smoking cigarettes.
4) In addition to nicotine, a cigarette puts about 4000 other chemicals into your body. The stop-smoking medications are inherently much safer.

I know people who became addicted to the nicotine gum. I am fearful of this. Should I just use the nicotine patch?

Research indicates that you should use what you feel most comfortable with as long as it is safe. Zyban, the transdermal patch and nicotine gum have about the same success rate if taken correctly for your personal situation. (If you smoked more than 15 cigarettes per day on average over the past year, you should start with the strongest strength of nicotine patch and gum).

The risk of gum users remaining dependent on nicotine gum has been reported to be as high as 10%. This is not a justifiable reason to avoid using the gum. The risk of becoming addicted to the gum is small compared to the risks of inhaling tobacco smoke. The research proving the gum to be effective would fill a small room.

Two ex-smokers, who thought they were addicted to nicotine gum, just started chewing regular gum instead and did not have any withdrawal effects at all.

My dad cannot use Zyban (bupropion) because he has epilepsy. Who should not take Zyban?

Zyban should not be taken by people with seizure problems, who take Wellbutrin, have eating disorders such as bulimia, are allergic to bupropion or taking a special antidepressant called a monoamine oxidase inhibitor (MAOI). You should abstain from alcohol while taking bupropion. People stopping smoking should not take alcohol anyway!

My friend uses Nicorette gum but still smokes. Is this recommended?

No. Nicorette gum has long been used by smokers to cope during long overseas air flights and to keep daily tobacco consumption down by smokers who are unwilling or unable to quit. The short answer is you should quit. If you can’t, talk to your doctor or other health care provider about some counselling and intensive support to help you quit. Occasionally some patients in a stop smoking programs will temporarily use nicotine replacement to help them reduce tobacco consumption as a form of harm reduction.

Whether this helps the success rate or health is uncertain. Strongly consider adopting a heart healthy lifestyle and quit smoking. Never use the nicotine patch and smoke.

What are the side effects of the transdermal nicotine patch?

Most commonly, localized mild skin reactions occur and may be managed by rotating patch sites and if necessary applying topical corticosteroid cream. Short-lived skin reactions when the patch is initially applied are common & should disappear within an hour. Allergy to one or more of the patch components may cause marked redness, swelling or rash.

Some clients experience adverse side effects including headache, nausea, insomnia & dizziness, although nicotine withdrawal symptoms may also simultaneously occur. Vivid dreams or nightmares have been described in up to 15% of patch users. These clients may benefit from 16 hr patches or removing the patch before bedtime. This should be avoided if possible as morning nicotine is often very desirable.

What is all the talk about the patch and the gum helping reduce weight gain in people who quit smoking?

For many people, bupropion & the nicotine gum or transdermal patch, along with improved eating habits & physical activity, has been shown to delay weight gain after quitting. The use of bupropion also significantly delays some of weight gain associated with smoking cessation for up to six months. When compared to the transdermal patch, Nicorette gum appears to delay weight gain more effectively.

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