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Efficiency: Using NRT with other methods improves success.
How does it work? Replaces nicotine to help reduce physical craving.
Nicotine Patch (Habitrol, Nicotrol, Nicoderm CQ, Prostep)
Efficiency: 2 regimens: 21 mg every day (usual); low dose for patients
under 100 pounds, light smokers (less than 10 cigarettes/day), or
those with cardiovascular problems: 14 mg every day x 2-4 wks. Discharge.
Side Effects: Sleep disturbance. Local skin reactions, may treat
with hydrocortisone cream; do not use in pregnancy
Educational Points: Start on Quit day. Plan on 8 weeks of therapy.
Apply new patches each day on a relatively hairless location between
head and waist. Stop smoking before applying first patch. Do not
smoke while on patch.
Cost: Approximately $30 per week or $ per patch.
How does it work? Large bandaid that contains nicotine. Absorbs
through skin.
How are they available? 1) Over the counter (OTC). - Nictorol TM
(daytime use only), Nicoderm TM 2) Available with prescription only
- Habitrol TM, ProStep TM
Can I smoke while using? No, do not smoke or use any other tobacco
product since it could drive nicotine levels in the blood to dangerous
levels.
Who can use? Tolerated by most individuals with minimal problems.
Conditions that require review by a physician before using: skin
disease, cardio-vascular or peripheral vascular diseases, kidney
or liver diseases, endocrine disease (including diabetes), heartburn,
hypertension, pregnancy, nursing mothers, body weight under 100
pounds.
Nicotine gum (Nicorette CQ) (transmucosal sustained – release
medication)
Efficiency: Higher dose (4 mg) more effective in heavier smokers.
Most effective with behavioral programs.
Side Effects: Dizziness, nausea, dyspepsia, sore jaw, oral ulcers,
palpitations. Nicotine that is swallowed with saliva or washed down
with liquids will not be effective and may cause heartburn or other
GI complaints.
Educational Points: Start on quit day. Use gum as needed for urge
to smoke or on a schedule. Nicotine is released by contact with
saliva in the mouth. Chew slowly until spicy-peppery taste or tingling.
Then park gum between gum and cheek until spicy taste disappears,
allowing nicotine to be absorbed. Rechew gum gently every few minutes
for half-hour, then discard. Max. 30 pieces/day. Use for up to 3
months. Avoid acidic beverages. Chewing gum too fast may lead to:
lightheadedness, nausea and vomiting, throat/ mouth irritation,
hiccups, stomach upset, mouth ulcers, jaw muscle ache, headache,
and heart palpitations.
Cost: For 48 pieces: 2 mg. Pieces: $27-34 4 mg pieces: $30-40 Starter
kits, with user’s guide, an audio tape and 108 pieces of gum:
$34-49 (2 mg.) $50-56 (4 mg) Up to 30 pieces of 2 mg. Gum can be
used on a daily basis.
How does it work? A sugar-free gum which contains nicotine.
How are they available? Over the counter.
Can I smoke while using? No, do not smoke or use any other tobacco
product since it could drive nicotine levels in the blood to dangerous
levels.
Who can use? Good option for most people. However, the following
people should consult with a physician before using: women who are
or might be pregnant, nursing mothers, patients with heart problems
or active TMJ (temporomandibular joint disease).
Nicotine nasal spray (Nicotrol NS)
Efficiency: Nicotine absorbed through nose. Yields faster relief
than patch or gum.
Side Effects: Very irritating to nose and throat; dependency possible.
Don’t inhale because medication could flow directly into sinus
cavity.
Educational Points: Start on quit day. One spray in each nostril
every 30 to 60 minutes as needed for cravings (0.5-mg spray). Max
= 40 doses/day. Use careful spray technique; don’t sniff,
swallow or inhale spray. Max. treatment = 3 months (8 mg/day for
12 wks.). Plan to taper doses and quit. Point spray toward outside
of nostril.
Cost Variable: From $40-47 for a 10 ml bottle. A 10-ml bottle lasts
an average of one week, but varies from person to person, depending
on how heavily a person smoked before quitting.
How does it work? Solution containing nicotine that is sprayed into
both nostrils.
How are they available? Prescription (Rx) from provider
Can I smoke with using? No, do not smoke or use any other tobacco
product since it could drive nicotine levels in the blood to dangerous
levels.
Who can use? Conditions that require review by a medical provider
before using: pregnancy, nursing mothers, persons with heart problems
high blood pressure, drug allergies, diabetes requiring insulin,
kidney or liver disease. Persons with asthma or chronic nasal disorder
(allergies, rhinitis, nasal polyps and sinusitis) should not use
the nasal spray.
Nicotine inhaler (Nicotrol)
Efficiency: Doubles smoking cessation rate vs. placebo. 100 drags
= 1 cigarette
Side Effects: Cough, mouth and throat irritation.
Educational Points: Start on Quit day. 4 mg nicotine in each cartridge.
Use 6 cartridges daily for 6-12 wks. Then if needed, reduce gradually
over 12 more weeks, then discontinue. Max treatment = 6 months.
Requires effort and practice to obtain adequate nicotine by inhalation.
Cost Variable: $50-60 for 42-cartridge box (1-week supply)
How does it work? Dry powder that is inhaled into lungs –
through the mouth via aerosol cartridge.
How are they available: Prescription (Rx) from provider
Can I smoke with using? No, do not smoke or use any other tobacco
product since it could drive nicotine levels in the blood to dangerous
levels.
Who can use? Consult provider for conditions that require review
by medical provider allergies and asthma.
Buproprion (Zyban, Wellbutrin SR) (antidepressant)
Efficiency: Reduces withdrawal symptoms, nicotine craving. Most
effective if used with counseling program; may be used with NRT.
Side Effects: Insomnia, dry mouth, headache, anxiety, skin rash.
Educational Points: Start 1 week before quit date. Avoid use before
sleep. Dose: 150 mg once per day for 3 days, then 150 mg twice per
day for 8-12 wks.
Cost Variable: Approx. $2.70 per day (same as 1 pack of cig.s).
From $75-86 for a 60-tablet (150 mg) one month supply. Recom-mended
course of therapy is two months. How-ever, MD’s can prescribe
Zyban for 7–12 weeks.
How does it work? Sustained release tablets that counteract central
nervous system withdrawal effects.
How are they available? Prescription (Rx) from provider.
Can I smoke while using? Only during first week of treatment
Who can use? Consult provider before using: pregnancy, nursing mothers,
persons with seizure disorders, eating disorders, and persons already
taking any antidepressant.
Nortriptyline (Pamelor) (tricyclic antidepressant)
Efficiency: Tested in smokers without depression. Higher quit rate
at 6 months vs. placebo.
Side Effects: May include: sedation, tremors, seizures, dry mouth,
light sensitivity, mood swings.
Education Points: Start 14 days before quit date. Dose: 25 mg once
per day for 4 days, 50 mg once per day for 4 days, then 75 mg once
per day for 12 weeks.
Cost Variable: Slow release tablets that counteract central nervous
system withdrawal symptoms.
Who can use? Prescription (Rx) from provider
Clonidine (Catapres) (CNS-acting alpha agonist)
Efficiency: Reduce withdrawal symptoms
Side Effects: Schedule regular eye exams, as Clonidine can affect
the retina.
Educational Points: Use under supervision of your doctor.
How does it work? Slow release medication that helps reduce withdrawal
symptoms. Time release patch is less sedating than pill. Over time
you may require a higher dose.
How are they available? Prescription (Rx) from provider
Can I smoke while using? Yes – but not recommended
Who can use? Conditions that require review by medical provider
if heart trouble, disease of the blood vessels in the brain, or
chronic kidney failure.
Efficiency: May be helpful as part of a whole program.
Side Effects: Side effect possible. Ask a Qualified Herbalist.
How are they available? Over the counter
Citrol (citric acid dietary supplement)
Efficiency: Provides airway sensation replace-ment; may be useful
when combined with other therapies.
Side Effects: Avoid use in hypersensitive airways.
Educational Points: Spray 2-4 times directly to back of throat to
reduce desire to smoke for approx. 1 hr. Use as needed.
Cost Variable: $4.99 for 100-spray bottle (mail order)
How does it work? Sustained release tablet
How are they available? Over the counter Herbal/vitamin Section
Can I smoke while using? Yes – but not recommended
Clinician counseling and support
Efficiency: Counseling increases success rate.
Cost Variable: Cost varies with insurance. Check for coverage.
How does it work? Helps person learn methods to deal with addiction
cessation.
How are they available? Individual call appointment’s in clinic
at 715-483-3221.
Can I smoke while using? Not recommended
Who can use? Everyone
Hypnosis
Efficiency: May be helpful as part of a whole program.
How are they available? Check with the American Cancer Association.
Behavior modification: i.e.: Relaxation, problem solving, exercise,
distraction, positive affirmation.
Efficiency: Effective
Educational Points: Review previous quit successes and failures.
Plan for dealing with urges.
How does it work? Varible depending on method used.
How are they available? 1) See packet action plan. 2) Counselor,
other programs and medical provider.
Can I smoke while using? Not recommended
Who can use? Everyone
Acupuncture
Efficiency: May be helpful as part of a whole program
Educational Points: Patient may benefit.
Cost Variable: Variable
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