Quit Meds: Facts and FAQs
Nicotine replacement therapy (NRT)
Nicotine replacement therapy like the patch or gum works by reducing the symptoms of withdrawal and cravings caused by quitting smoking. It delivers a controlled dose of nicotine to your body over time. Each product is available in different doses so talk with your pharmacist or other healthcare professional about the correct dose for you.
NRT currently comes in 5 forms: patch, inhaler, gum, lozenge and oral spray. Each is available without a prescription at your drugstore, and the cost varies from approximately $4 to $8 a day. Although they all contain nicotine, they are much safer than tobacco and they don’t cause cancer. Before using NRT, be sure to speak with your pharmacist, doctor, or other healthcare professional about medicines you are currently taking and what option might be best for you.
The patch is applied to your skin and delivers a continuous controlled dose of nicotine.
Applying the patch to your skin allows nicotine to enter your body slowly, helping to reduce cravings and withdrawal symptoms.
Start using the patch as soon as you stop smoking. It is usually not recommended to smoke while on the patch. It probably won’t harm you, but by doing both, you could get too much nicotine. The patch should be applied to a clean, dry area above your waist.
The inhaler looks similar to, but is shorter than, a cigarette. It’s a plastic cylinder that holds a cartridge containing nicotine.
By puffing on the inhaler, nicotine vapour is released and absorbed through the lining of your mouth.
The vapour is not designed to be inhaled into your lungs like a cigarette, but rather should be puffed on lightly so that the vapour stays in your mouth. The inhaler should be cleaned regularly with soap and water. Avoid drinking acidic beverages such as coffee, tea, soft drinks, alcohol and citrus juices when using the inhaler because they can prevent it from working properly.
The gum contains nicotine that is absorbed through your cheek. It can be used to cut down on the number of cigarettes you smoke per day. Nicotine gum is available in several flavours.
It enters your body slowly and provides nicotine over 20–30 minutes.
Bite the gum once or twice and then park it between your gum and cheek until you no longer feel a “Tingle”. This may take up to 20–30 minutes. Bite it occasionally but don't chew it rapidly like regular gum. Use only one piece of gum at a time. It’s important to follow the instructions on the package about how to chew the gum; otherwise, it may not work properly, and you might not get the right effect from it.
The lozenge comes in the form of a hard candy.
The lozenge slowly releases nicotine as it dissolves in your mouth.
Place one lozenge in your mouth and slowly suck it until you notice a strong taste. Then park it between your cheek and gum. Wait until the taste fades, and suck it until you again notice a strong taste. Then park it again. It should take 20–30 minutes to dissolve. Do not chew or swallow the lozenge. It’s important to follow the instructions on the package; otherwise, it may not work properly, and you you might not get the right effect from it.
The oral spray is a liquid that is sprayed into the mouth.
When sprayed, the vapour releases nicotine that is absorbed through the lining of the mouth.
Avoid spraying the vapour on your lips or down your throat. To avoid spraying down your throat, do not inhale while spraying. Avoid drinking acidic beverages such as coffee, tea, soft drinks, alcohol and citrus juices when using the spray because they can prevent it from working properly.
Prescription medications
There are currently 2 quit-smoking medications you can get that need a prescription from your doctor: Champix and Zyban. Both are available in pill form and actively target your brain and how it processes nicotine. They cost about $3 to $5 a day.
Champix (Chantix in the US) is available in pill form, and it does not contain nicotine.
It stimulates the same areas of the brain that nicotine does to prevent the pleasurable effects of smoking. This helps to reduce cravings and withdrawal symptoms.
There are 2 ways to set your quit date when using Champix. Follow the instructions on the package or talk to your doctor or pharmacist about which way is best for you.
Zyban is available in pill form and has also been used for treating depression. When used for depression it’s sold as Wellbutrin. It does not contain nicotine and it is not addictive.
It stimulates the same areas of the brain that nicotine does to help reduce cravings and withdrawal symptoms.
It’s important to set a quit date before you start taking Zyban. Start taking Zyban 7 to 10 days before your quit date.
Common concerns about quit aids
There are questions and concerns that come up when talking about quit-smoking medications. Here are some questions and answers.
The ongoing costs of smoking are more than the short-term costs of medications. Also, for some, quit-smoking medications may be free as part of your private health insurance plan or through your provincial health plan. If you have personal health coverage or participate in a health plan through your employer, contact your health insurance company to see what they cover.
Nicotine Replacement Therapy (NRT) gives your body nicotine but at a much lower lever than smoking. It enters your body less quickly and by a much safer route. You avoid inhaling more than 70 cancer-causing chemicals and the poisonous carbon monoxide found in tobacco smoke. As your cravings become more manageable, you can reduce the amount of NRT that you use. Talk to your pharmacist or other healthcare professional if you have any concerns about the products you are taking.
This is false. Nicotine is not one of the cancer-causing agents in cigarettes – it’s the tar, carbon monoxide and some of the other 4,000 chemicals in cigarettes that can cause cancer. NRTs help get the nicotine into your body while you quit but without the added dangers.
If you’re pregnant, it’s a great time to quit! Most prescription medications are not recommended during pregnancy, but talk to your doctor or midwife about NRT or other options that may be available to you. For more information on tobacco and pregnancy, visit www.pregnets.org.
Discuss possible risks of taking Champix with your doctor. Many people have had success with it. When you quit smoking, it’s normal to have feelings of depression, insomnia, irritability, frustration, anger or anxiety. Some people have even experienced suicidal thoughts. Sometimes quitting smoking can lead to worsening of mental health problems that you already have. If you have a history of mental health conditions, you should be closely monitored by your doctor while taking Champix. Drinking alcohol may increase the risk of experiencing mental health side effects. If you are experiencing or family members/caregivers observe any concerning symptoms (e.g. unusual change in mood, behaviour, suicide ideation, worsening of psychiatric symptoms or allergic reactions including swelling or a rash) after starting Champix you should stop taking Champix and contact your doctor right away. If you have a history of mental health problems your healthcare provider may adjust your dose of Champix or other medication which may make a difference.
Some people have found these to be useful; however, there is no evidence to support that either of these treatments are effective. The same is true for other alternative quit methods like herbal supplements, herbal patches, laser therapy or electronic cigarettes (e-cigarettes). In fact, Health Canada advises that e-cigarettes should not be used because they may pose health risks and have not been fully evaluated for safety and quality. Visit Health Canada’s website at www.hc-sc.gc.ca.