What are my options for OTC and prescription smoking cessation drugs

It’s never too late to quit smoking. Your risk for disease and early death is greatly reduced when you stop. There are health benefits at any age—and the sooner you stop, the greater they are. 

There are many different effective smoking cessation drugs to help you kick the habit. It’s important to find the stop-smoking aid that works best for you and that will help you give up cigarettes for good.

Why is it so hard to quit smoking?

Nicotine is the primary substance in tobacco products that causes addiction. When you try to quit smoking, you may have symptoms of nicotine withdrawal because your body is dependent on the effects of nicotine. Common symptoms of nicotine withdrawal include irritability, anxiety, trouble sleeping, and increased appetite. The discomfort they cause can make you want to pick up the habit again, just to be rid of them. 

7 stop-smoking aids that work

Fortunately, there are different options that help you gradually wean off of nicotine and reduce the withdrawal symptoms that make it so hard to quit. 

1. Nicotine gum
2. Nicotine lozenges
3. Nicotine patch
4. Nicotine inhaler
5. Nicotine nasal spray
6. Non-nicotine tablets (Chantix, Zyban)
7. Off-label medications

RELATED: Wellbutrin vs. Chantix

Pharmacotherapy for smoking cessation falls into two main categories: nicotine replacement therapy and non-nicotine smoking cessation products.

Nicotine replacement therapy (NRT)

Nicotine replacement products provide consistent levels of nicotine that gradually decrease over time. 

NRTs are available in different formulations and strengths: over-the-counter (OTC) and prescription. They are indicated by the U.S. Food and Drug Administration to be used for eight to 12 weeks but can be used longer if you and your healthcare provider feel that it is necessary. 

OTC NRTs

The OTC products are all available from various name brands and as generics. They include:

• Gum is slowly chewed until it tingles. Then place the gum between the cheek and gum until the tingle is gone. Repeat this process until most of the tingle is gone (approximately 30 minutes). Nicorette is a common brand name.
• Lozenge should be allowed to dissolve slowly (approximately 20-30 minutes) and should not be chewed or swallowed. Nicorette is a common brand name.
• Patch is applied to a clean, dry area of your skin on the upper body or upper outer arm. Patches may be worn for 16-24 hours, and every patch should be applied to a different site to avoid skin irritation. Nicoderm Cq is a common brand name.

Prescription NRTs

The prescription formulations of NRT are only available under the brand name Nicotrol and are available as: 

• Inhaler formulation is breathed in by mouth multiple times a day. It may cause irritation of the mouth or throat when first using the inhaler. Nicotrol is a common brand name.
• Nasal spray is sprayed in the nose multiple times a day. It may cause irritation in the nose or throat when you begin using it.

Before beginning any NRT product, you should always consult your healthcare provider, especially: 

• Women who are pregnant or breastfeeding
• People with diabetes, asthma, or a heart condition
• People with high blood pressure or irregular heartbeat

You should stop taking an NRT product and call your healthcare provider if you have any of the following symptoms: nausea, dizziness, vomiting, or irregular heartbeat.

Non-nicotine smoking cessation products

If you can’t use an NRT product because of a health condition, or you know you won’t remember to use it multiple times a day, there are two prescription smoking cessation drugs available in tablet form:

• Varenicline tartrate
• Zyban (bupropion hydrochloride)

Both of these stop-smoking aids affect chemicals in your brain to help reduce your nicotine cravings and are taken twice a day. The duration of therapy for these medications is generally 12 weeks, but if you’ve successfully quit smoking, it can be used longer to reduce the risk of smoking relapse. 

*Varenicline tartrate was sold by its brand name Chantix, but in July 2021, Pfizer paused production and recalled the drug due to increased nitrosamine levels. The FDA later approved the generic version, which is what is widely available now.

Off-label medications to quit smoking

For smokers who are not successful with one of these treatments, some physicians will prescribe other medications off-label to help. Off-label just means the FDA does not approve them for this particular use. According to the American Cancer Society, these options include nortriptyline (antidepressant), clonidine (antihypertensive), cytisine (plant compound), and naltrexone (opiate antagonist).

Side effects of smoking cessation drugs

The FDA has issued some cautions for taking these smoking cessation medications but has determined that the benefits of quitting smoking outweigh the risk of taking these medications. You may experience adverse effects to your mental health. If you notice any changes in mood or behavior while taking these medications, report them to your healthcare provider and stop taking the medication. 

Some common side effects of varenicline tartrate include nausea, sleep problems, constipation, gas, and vomiting. 

For Zyban, common side effects include dry mouth, insomnia, dizziness, constipation, and nausea. 

If you are considering medication to stop smoking, speak with your healthcare provider or pharmacist.

RELATED: Should you take Wellbutrin to stop smoking?

Compare smoking cessation drugs

 

Drug name	Form	Rx / OTC	Side effects	SingleCare coupon
Nicorette	Nicotine gum	OTC	Mood swings, drowsiness, difficulty concentrating, increased appetite, aches and pains, constipation	Get coupon
Varenicline tartrate	Non-nicotine tablet	Rx	Nausea, sleep problems, constipation, gas, vomiting	Get coupon
Nicorette	Nicotine lozenge	OTC	Mood changes, fatigue, trouble concentrating, weight gain, aches or pains, constipation	Get coupon
Nicotrol NS	Nicotine nasal spray	Rx	Nose or throat irritation	Get coupon
Nicotrol	Nicotine inhaler	Rx	Mouth or throat irritation	Get coupon
Nicoderm Cq	Nicotine patch	OTC	Application site irritation, dizziness, headache, stomach upset	Get coupon
Zyban	Non-nicotine tablet	Rx	Dry mouth, insomnia, dizziness, constipation, nausea	Get coupon

 

RELATED: Wellbutrin vs. Chantix

Frequently asked questions

What does smoking cessation mean?

Smoking cessation is a process of quitting the use of tobacco. Tobacco contains a chemical called nicotine. Nicotine is addictive and causes withdrawal symptoms (cravings, nausea, irritability, mood swings, weight gain, etc.), making smoking cessation a difficult process.

What are smoking cessation products?

There are two categories of smoking cessation products:

1. Nicotine replacement therapy: Gum, lozenges, patches, nasal sprays, and inhalers that contain a lower dose of nicotine compared to smoking and reduce withdrawal symptoms.
2. Non-nicotine smoking cessation drugs: Oral prescription medications that do not contain nicotine but reduce withdrawal symptoms, such as cravings.

What is the most effective stop-smoking aid?

There isn’t a universally effective stop-smoking aid. A healthcare professional can help you find the best stop-smoking aid for you.

Nicotine replacement therapy methods are equally effective and increase smoking cessation rates by 150% to 200%. One clinical trial revealed no statistical significance between the products. However, another study found that Chantix was more effective than Zyban.

Note: E-cigarettes are not effective stop-smoking aids. Most studies show that e-cigarettes and other vaping devices do not significantly reduce cigarette use, according to Partnership to End Addiction.

What tablets can you take to stop smoking?

Chantix and Zyban are two types of tablets you can take to stop smoking. However, there are other off-label medications in capsule or tablet form that a healthcare provider may prescribe depending on your situation. These include clonidine (tablet), nortriptyline (capsule), and naltrexone (tablet).

Is smoking cessation free?

Smoking cessation could be free with insurance. Almost all health insurance plans (Marketplace, Medicaid, and Medicare Part D) cover smoking cessation therapies.

If you don’t have health insurance, you can still save on smoking cessation drugs with manufacturer coupons and prescription discount cards like SingleCare.

RELATED: How to get free Chantix (even without insurance)

How can I quit smoking without medication?

You can successfully quit smoking without medication. Group therapy and quitting “cold turkey” are non-pharmacological approaches to smoking cessation. Those participating in group-based smoking cessation programs are 50% to 130% more likely to quit smoking. Additionally, quitting “cold turkey” and abstaining from nicotine altogether could be the healthiest approach to quitting smoking. However, withdrawal symptoms from this method are likely to be more severe than a gradual program with nicotine replacement therapies.