you deserve to stop smoking - texas children's hospital...addictive way of relieving cravings...

You Deserve to

ComfortablySTOP SMOKINGClarifying myths about medications to help youSTOP SMOKING

Stop Smoking. The Time is Now.

Tobacco-Dependence Treatment Tool Kit, 3rd Edition

American College of Chest Physicians3300 Dundee Road, Northbrook, Illinois 60062-2348 | (847) 498-1400 | (800) 343-2227

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Q: My doctor recommends that I take an antidepressant to stop smoking. Won’t this change my personality?

A: When used for smoking, these medications are not expected to change your personality. These medications help prevent cravings after you stop smoking. Should you experience dramatic changes in anxiety levels and/or mood states, see your doctor at once.

Q: Is it safe to use more than one of these medications at a time?

A: Under a doctor’s direction, it is safe to use several of these medications in combination. Your doctor may recommend more than one because together they can be more effective than alone.

Q: What is Nicotine Replacement Therapy (NRT)?

A: Nicotine Replacement Therapy is an alternate way of delivering nicotine to the brain. It comes in several forms that can be used alone or in combination. NRT provides a safe, non- addictive way of relieving cravings while you stop.

Q: Isn’t it better not to have nicotine in my body?

A: Nicotine is not the harmful part of a cigarette. Also, the level of nicotine delivered by NRT is significantly lower than that delivered by a cigarette. The thousands of other toxins present in tobacco smoke are the dangerous parts. By temporarily substituting a safe form of nicotine for cigarette smoke, your body has a chance to adjust to not smoking in a safe way. In fact, NRT is always safer than smoking.

Q: Won’t I become addicted to the patch?

A: No. Addiction is not just about the presence of nicotine, but rather about how fast it gets to the brain. It takes just a few seconds for the nicotine from a cigarette to reach the brain. Without this peak, you cannot become addicted. The patch delivers nicotine in a slower, more controlled way than a cigarette.

Q: If I smoke a cigarette while wearing the patch, will I have a heart attack?

A: No. An accidental cigarette while wearing the patch is not enough to cause health problems.


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If you happen to smoke a cigarette, don’t take the patch off. This may be a sign that a higher NRT dose is necessary. Talk to your doctor about adjusting your treatment plan.

Q: I heard that the gum does not work. Is that true?

A: When the gum is not as effective as it can be, it is usually for one of two reasons. First, if you are using it like chewing gum, it will not work. It has to be parked between the cheek and gum for the nicotine to be absorbed. Second, don’t be afraid to use enough. In the first few weeks of stopping, you can use 1 piece every hour.

Q: If the inhaler imitates the hand-to-mouth behavior, won’t using it make it harder to break the habit?

A: For most people, it is not the hand-to-mouth behavior that keeps them smoking; it is the nicotine. The biggest advantage of the inhaler is its ability to supply just the right amount of nicotine whenever you need it, faster than other forms of NRT. The inhaler works best when you use it at the beginning of a craving.

Nicotine Replacement Therapy and Bupropion, and Varenicline are safe and effective medications to help you stop smoking. However, all medications are more effective if used in combination with individual counseling from your health care provider or more structured group counseling. Talk to your health care provider if you have any questions or concerns.

For information regarding local counseling sessions call your local hospital or public health department. Other resources include:

American Cancer Society American Lung Associationwww.cancer.org www.lungusa.org(800) ACS-2345 (800) LUNG-USA866-QUIT-YES


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Name Description Advantages Common Tips AvailabilitySide-effects

NicotenePatch

Helps to preventcraving & othernicotine with-

drawal symptomsAvailable in

21mg, 14mg, 7mgGenerally start

with 21mg ifsmoking >10cigarettes/day

Easy to use

Provides steadydose of nicotine

for 24 hours

Skin irritationcan occur

Difficulty sleeping

Very few if usedcorrectly

Some patientsmay experience:mouth soreness,

hiccups, andheartburn

Change patchevery morning

and use adifferent siteevery day

If you have troublesleeping removebefore bedtime

Gum sbould bechewed until

soft and parkedbetween the

cheek and gums

Lozenge shouldbe parkedunder the

tongue

Nicoderm CQ

Generic patches

Nicorette,Nicorette Mint,and Nicorette

OrangeGeneric Gum

CommitLozenge

(No GenericLozengeAvailable)

NicotrolInhaler

(No Genericavailable)

To avoid side effects, propertechnique is

important

Follow packageinstructions

showing properinhalation techniquethrough the mouth

Cough, if inhaledtoo deeply

Used in responseto craving or any

acute nicotinewithdrawalsymptom

Flexible dosebased on your

nicotine withdrawalsymptoms

Helps controlweight gain

Used in responseto craving or any

acute nicotinewithdrawalsymptom

Flexible dosebased on your

nicotine withdrawal

Helps treat sudden

onset of nicotinewithdrawalsymptoms,

including cravingAvailable in 2mg

and 4mgCan be used in

combinationwith the patch

Helps treat sudden

onset of nicotinewithdrawal

symptoms, includingcraving

Each cartridge delivers 4mg of

nicotine, approx.80 “puffs”

NicoteneGum /

NicoteneLozenge

Very few if usedcorrectly

Some patientsmay experience

stinging or burningin nostrils; lessens

in a few days;not of medical

concern

To avoid sideeffects, propertechnique is

important

Follow packageinstructions

showing propernasal inhalation

technique

Nicotrol Nasal Spray (NNS)

(No GenericAvailable)

Will relieve cravingor any acute

nicotine withdrawalsymptom the

fastest of any NRTFlexible dose based

on your nicotinewithdrawal symptoms

Helps treatsudden onset of

nicotine withdrawalsymptoms,

including craving1 Dose = 1 Spray

in each nostril(each Spray

delivers 0.5-mg nicotine)

NicotineNasalSpray

Nicotene OralInhaler

Ove

r the

Cou

nter

Pres

crip

tion

Onl

y


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Name Description Advantages Common Tips AvailabilitySide-effects

Pres

crip

tion

Onl

y

Zyban

Wellbutrin

GenericBupropion

If you have troublesleeping, try taking2nd tablet earlier

in the evening(i.e., after dinner) orswitch to once-a-day

formulation(Bupropion XL)Dry mouth and

agitation usuallygo away after a

few days

Difficulty sleeping,vivid dreams,

dry mouth,agitation

Available as onceor twice-daily

tablets taken bymouth

Can be combinedwith NRT

Reduces all nicotinewithdrawal

symptoms, includingurge to smoke

Helps reduce cravings

Begin treatment7-14 days

before stop dateDay 1-3: 1 tabletevery morningDay 4-end of

treatment: 1 tablettwice daily

BupropionSR

Chantix(No Genericavailable)

Most commonside effects areusually mild and

go away inthe 1-2 weeks

before stop days

Nausea, abnormaldreams,

constipation,excess gas, drymouth, vomitting

Available as twice-daily tablets taken

by mouthSingle-most effective

medication of allavailable, whenused by itself

Can be combinedwith bupropionand also NRT

Reduces all nicotinewithdrawal

Helps reducenicotine withdrawal

symptoms, includingcraving forcigarettes

Begin treatment7-14 days before

stop date

Day 1-7: Use “StartingMonth PAK”; takethe 0.5-mg tablets

as directed onthe box label

Varenicline

(cont’d)

you deserve to stop smoking - texas children's hospital...addictive way of relieving cravings...

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