Medications to Help Stop Smoking

Smoking has many negative health effects, and it is a good idea for anyone who smokes to quit. For people with chronic obstructive pulmonary disease (COPD), quitting smoking is especially important. If you are a smoker, quitting is the most important thing you can do to treat your COPD.^1,2

Health benefits of quitting smoking include:^1,2

• Reducing the impact of COPD symptoms
• Lowering the risk of reaching severe stages of COPD
• Improving your quality of life
• Lowering the risk of other health issues like cancer or heart disease

However, quitting smoking is not easy. The nicotine in tobacco products is very addictive. Once you are a regular smoker, it is a difficult habit to break. Two types of medicines can help people stop smoking and make them more likely to quit for good. These are called:¹

• Nicotine replacement treatment (NRT)
• Smoking cessation drugs, available only by prescription

By using nicotine replacement products and/or smoking cessation drugs, people are much more likely to be successful in quitting smoking.¹

Nicotine replacement treatment

Nicotine is the main addictive chemical in tobacco. When people regularly smoke, their body starts to become dependent on nicotine. If they try to quit, their bodies will go through withdrawal. This can cause physical discomfort.³

NRT works by delivering small amounts of nicotine into a person’s body. This can:³

• Reduce cigarette cravings
• Help people gradually get used to having smaller amounts of nicotine in their bodies
• Improve the chances of quitting tobacco

NRT is designed to deliver nicotine into the body without the harmful effects of tobacco smoke. NRT helps people get used to having smaller and smaller amounts of nicotine in their bodies, and eventually none. Types of NRT include:³

• Patches for the skin
• Gum
• Nasal spray (requires prescription)
• Inhalers (requires prescription)
• Lozenges

Some studies show that using NRT can double a person's chances of being able to quit smoking. However, NRT only addresses the physical dependence on nicotine. It does not help with the emotional aspects of quitting. NRT is also not approved by the US Food and Drug Administration (FDA) to be used at the same time as any other nicotine product. This means it is not approved for people who are still smoking or using any other form of tobacco.³

Prescription drugs that can help a person stop smoking

Other types of medicines can help people stop smoking without actually delivering any nicotine into the body. Studies have shown that these medicines can make people more likely to quit smoking long-term. They also have shown promise when combined with NRT to help people quit.⁴

These drugs include:⁴

• Varenicline (Chantix^®)
• Bupropion (Wellbutrin, Aplenzin^®)

Varenicline works by weakly mimicking the effects of nicotine in the body. This can help decrease the urge to smoke and make smoking feel less pleasurable. Common side effects include:⁴

• Nausea
• Headache
• Trouble sleeping
• Unusual dreams
• Constipation
• Vomiting

Varenicline has a boxed warning, the strictest warning from the FDA. It has this warning because can cause serious side effects on mood, behavior, and thinking, including depression, thoughts of suicide, and self-harm. Before taking varenicline, tell your doctor if you are currently being treated for or have previously been treated for mental health conditions like depression, anxiety, or schizophrenia.⁵

Bupropion is an antidepressant that impacts the chemicals in your brain that cause nicotine cravings. It is shown to help reduce cravings and the symptoms of nicotine withdrawal. Common side effects include:⁴

• Difficulty sleeping
• Dry mouth
• Dizziness
• Anxiety
• Nausea
• Constipation
• Stuffy or runny nose
• Headaches

Usually, you start taking one of these drugs a few weeks to a month before you plan to quit. You then continue taking them through the first few months without smoking. If your quitting process is going well, your doctor may extend the prescription to help your chances of not going back to smoking.⁴

These drugs are only recommended for people who have severe nicotine dependence. They are also not safe for people with certain health conditions. Talk with your doctor about your medical history and tobacco use if you are interested in varenicline or bupropion. Report any new or worsening mental health problems while taking these drugs to your doctor right away.⁴

Other prescription drugs that may help people quit smoking are being studied. However, none have been approved by the FDA at this time. There are also some older prescription drugs that may help people quit smoking. While these drugs are approved by the FDA for other uses, they are not approved for helping people quit smoking. This is called "off-label" use.⁴

If you are interested in learning more about what drugs may be right to help you stop smoking, talk to your doctor.