Cigarette smoking leads to a variety of avoidable health consequences, including cardiovascular disease, lung cancer and respiratory disease. Many medications are available for the treatment of nicotine dependence and are effective in producing long-term results. Any individual attempting to quit smoking should use these drug therapies unless otherwise indicated from a physician. The preferred treatments for smoking cessation include Nicorette (nicotine gum), Nicoderm CQ (nicotine patch), Nicotrol (nicotine inhaler), Commit (lozenge), Nicotrol NS (nasal spray), Chantix (varenicline) and Zyban (bupropion).
Nicorette
Nicorette is available over-the-counter and contains all instructions on its use on the package. A health-care professional such as a pharmacist may help in choosing the correct dose. "The 2-mg gum is recommended for patients smoking less than 25 cigarettes per day, where the 4-mg is recommended for patients smoking 25 or more cigarettes per day," states "Pharmacotherapy: A Pathophysiologic Approach." An individual should use this medication for 12 weeks and chew no more than 24 pieces of day; patients should seek the advice from a physician for use after 12 weeks.
Nicoderm CQ
Nicoderm CQ is another medication used for smoking cessation. Like Nicorette, the dose of the patch is based on how many cigarettes the person smokes. If an individual smokes more than 10 cigarettes a day, the higher dose should be used. The patch should be placed on a hairless spot on the body between the neck and waist. The patch should be removed before bedtime to avoid sleep disturbances and a new a patch should be placed on the body each day. The physician should inform the patient to not smoke while using the patch. The typical duration of treatment is between 8 and 10 weeks.
Nicotrol
Nicotrol is another medication that may be used for nicotine replacement. Each cartridge of the inhaler contains 10mg of nicotine and 1 mg of menthol. The individual will start by using 6 cartridges a day during the first 3 to 6 weeks; generally, 1 cartridge is used every 1 to 2 hours. Daily dosages should be reduced over the following 6 to 12 weeks.
Commit
Commit is used as a nicotine replacement therapy that is dosed according to the time when the patient starts to smoke. Patients who smoke their first cigarette within 30 minutes of waking should use the 4mg lozenges, while those who smoke the first cigarettes more than 30 minutes after waking should use the 2mg lozenges. During the first 6 weeks, the patient will consume 1 lozenge every 1 to 2 hours. During week 7 through 9, the patient will consume 1 lozenge every 2 to 4 hours and during week 10 through 12, the patient will consume 1 lozenge every 4 to 8 hours. Use beyond 12 weeks should be consulted with a physician.
Nicotrol NS
Nicotrol NS is a nasal spray available as a 10-ml spray bottle. Each bottle contains about 100 doses which deliver 1 mg of nicotine. The patient should insert one spray in each nostril to complete the one dose; typically, the patient will consume 1 to 2 doses per hour with at least 8 doses per day for the first 6 to 8 weeks. Then the patient should slowly decrease use over the next 4 to 6 weeks.
Chantix
Chantix is a prescription medication used to decrease symptoms of nicotine withdrawal. It works by blocking the stimulation responsible for reinforcement and reward associated with smoking. The patient will start therapy one week before the chosen quit date. The patient will take 0.5 mg once a day from day 1 to day 3, 0.5 mg twice a day from day 4 to day 7, and 1mg from day 8 to the end of treatment.
Zyban
Zyban is a prescription medication used for smoking cessation. It decreases the craving for cigarettes and decreases the symptoms of nicotine withdrawal. Initially, the patient will be given 150 mg every morning for three days followed by 150 mg twice a day for 7 to 12 weeks. If the medication is not effective after 7 weeks, the patient should seek medical advice.
References
- "Drug Information Handbook 15th Edition"; Lacy, Charles F., Armstrong, Lora L., et al; 2007
- "Pharmacotherapy: A Pathophysiologic Approach"; Dipiro, Joseph T., Talbert,Robert L., et al; 2008
