What prescription products are available for smoking cessation?

The following products for cessation of smoking are available by prescription only. Nicotine for nicotine replacement therapy is available by prescription as an inhaler or nasal spray (Nicotrol Inhaler and Nicotrol NS). These other forms of delivery of nicotine seem to work as well as the nicotine patches or gum.

Bupropion hydrochloride (Zyban, Wellbutrin) is a medication that is used primarily for treating depression. This drug, however, also has been found to be effective in helping people to quit smoking.

Other agents that have been tried for cessation of smoking include serotonin reuptake antagonists (drugs also used for depression) and the anti-hypertensive drugs clonidine (Catapres) and calcium channel blocker. Although these agents appear to be less effective than nicotine replacement therapy, they may be promising for some patients.

How are nicotine-containing products used safely?

Users of nicotine-containing products should understand that all of these products have side effects as well as effects on other underlying medical conditions such as diabetes mellitus, high blood pressure, asthma, and heart disease. Furthermore, these products can have interactions with other prescribed medications such as pain relievers, blood thinners, and high blood pressure medications. And finally, they do have their limitations. The following guidelines are to help you safely use these products to achieve your goal of quitting smoking.

1. Always read the labels and know the ingredients in the products. Never take more than the recommended dose without checking with your doctor first.
2. If you are pregnant or nursing a baby, seek the advice of a health professional before using any nicotine-containing product.
3. Do not use a nicotine-containing product if you continue to smoke, chew tobacco, use snuff, or other nicotine-containing products.
4. Consult a physician before using nicotine-containing products if you:

• Are under 18 years of age
• Have heart disease, an irregular heartbeat, or have had a recent heart attack (Nicotine can increase your heart rate.)
• Have high blood pressure that is not controlled with medication (Nicotine can increase your blood pressure.)
• Have a history of, or currently have, inflammation of the esophagus (esophagitis) or ulcers of the stomach or duodenum (peptic ulcer disease)
• Take insulin for diabetes.
• Take any prescription medications (Nicotine interacts with some medications, such as aspirin, some medications for the heart, and female hormones to decrease their levels in the blood.)
• Have a skin disorder, such as dermatitis, which may increase the likelihood of skin reactions by the skin to the patch

5. People should stop using nicotine-containing products and see their physician if they have or develop:

• Mouth, tooth, or jaw problems (applies to Nicorette gum)
• Irregular heartbeats or palpitations
• Symptoms of nicotine overdose, such as nausea, vomiting, dizziness, weakness, and rapid heartbeat
• Severe rash, redness, swelling, burning, or itching at the site of the patch