Five Newer Ways to Quit Smoking With Medicine

Most people who smoke have tried to quit many times, and it can feel as if nothing works. But much more is now known about what helps. These five approaches have been shown to work for adults and can make quitting easier, less unpleasant and more likely to succeed.

All of them are reviewed in Smoking Cessation: A Report of the Surgeon General, though not all have been evaluated or approved by the FDA. As with any health condition, talk with your health care provider.

1. Use more than one medicine

The most common combination is a nicotine patch plus nicotine lozenges or gum:

• Put on a new patch each morning for a steady level of nicotine that eases cravings and withdrawal all day.
• Use a fast-acting lozenge or gum to knock down cravings as they come.
• You decide how often to use the fast-acting product, so you get no more nicotine than you want.

It's easy, and using two nicotine replacement therapies (NRTs) together helps more people quit than using one alone.

2. Try varenicline

Varenicline is a pill with no nicotine that works differently from other quit-smoking medicines. It attaches to the same parts of the brain that nicotine stimulates, leaving fewer places for nicotine from a cigarette to attach — so it's harder to get a nicotine "buzz."

When you smoke, nicotine attaches to brain-cell receptors, releasing dopamine that makes you feel good (CDC).

Varenicline blocks those receptors but still triggers some dopamine release, so you don't feel as bad (CDC).

Varenicline:

• reduces the urge to smoke and the enjoyment of cigarettes;
• gives the strongest chance of success of any single medicine;
• is started a week or more before your quit day.

3. Get free coaching

A quit coach, doctor or pharmacist can help you choose a medicine and dose, solve problems with it, and cope with urges to smoke.

• Call 1-800-QUIT-NOW (1-800-784-8669). You'll reach a trained quit coach who will listen, support you and share proven tips and tools — for free. Quitlines can sometimes help you get free quit-smoking medicine too.
• Talk with your doctor or another health professional, who can offer encouragement, suggestions, prescriptions and referrals — and explain how much quitting will help your health.

4. Get medicine free or for less

With health insurance: most plans cover FDA-approved quit-smoking medicines, including over-the-counter ones — though you may need a prescription for your insurer to pay.

Without insurance: quitlines may be able to send free patches, lozenges or gum to your home. Nicotine patches can cost much less than a pack of cigarettes, and once you quit, you'll keep the money you used to spend on smoking.

Other ways to save:

• Tell your doctor or pharmacist cost is a concern; they may suggest a cheaper option that still works.
• Shop around — prices for the same medicine vary a lot between stores and brands.
• Look for coupons and discount programs online or ask your pharmacist (online prices may differ from what you'd pay with insurance).
• Buy a larger supply, which is often discounted and may help you stick with the medicine longer.

5. Start before your quit day

• It's fine to start nicotine patches, gum or lozenges a week or two before you quit. This can help you prepare and may cut down your smoking; starting early, especially with the patch, may improve your chances. Do it as part of a real plan to quit completely, ideally within a week or two.
• Quit-smoking pills (varenicline or bupropion) are recommended to be started a week or more before quitting; your doctor will advise on timing.

Free help to quit

Call 1-800-QUIT-NOW (1-800-784-8669), or in Spanish 1-855-DÉJELO-YA (1-855-335-3569); text QUITNOW to 333888; try CDC's quitSTART app; or visit Smokefree.gov.

Sources

• Centers for Disease Control and Prevention, Tips From Former Smokers: "Five New Ways to Quit With Medicines"; a work of the United States government in the public domain.