Consider Using Medicines to Help You Quit

Research has shown that using a quit-smoking medicine, such as bupropion (Zyban^®), varenicline (Chantix^®), or the nicotine patch, gum, nasal spray, inhaler, or lozenge, can double your chances of successfully quitting.

• Bupropion is a non-nicotine, prescription medicine that helps reduce cravings. 
• Varenicline is a drug that helps lessen nicotine withdrawal symptoms and lowers the feelings of pleasure people get from smoking. 
• Nicotine replacement products such as the patch, gum, lozenge, or spray can help with uncomfortable physical withdrawal symptoms, giving you the chance to concentrate on changing the "habit" or routine of smoking.

Talk to your doctor or health care provider about setting up a medicine strategy that will work for you. Depending on your smoking habits and previous attempts to quit, your doctor may recommend using one or more of these medicines. It is likely, though, that your doctor will not recommend using varenicline with nicotine replacement products. Varenicline was given along with NRT (nicotine replacement therapy) in early testing of the drug. The 2 drugs together resulted in more unpleasant side effects than varenicline alone.

For some patients, doctors may recommend use of 2 forms of nicotine replacement at the same time. For instance, a patch is sometimes used along with the spray or gum to better control cravings.

If a person is having a lot of trouble quitting, some doctors prescribe bupropion to be used at the same time as NRT. It will depend on your health, what other medicines you are taking, and the safety of using both at the same time.

Get Self-help Materials to Guide Yourself Through the Quitting Process

Materials are available to help you quit smoking, no matter where you are in the process. You can use the materials to learn how to prepare for your quit attempt, develop plans to help with cravings, and prevent relapse once you have quit. The self-help materials offer proven methods that are easy to follow and can keep your motivation high. The American Cancer Society's Break Away From the Pack series has been shown to double your chances of quitting successfully. This material is available for those who are willing to quit smoking. For more information on Break Away From the Pack or other self-help materials from the American Cancer Society, call 1-800-ACS-2345 (1-800-227-2345).

Find Out About Support Programs Near You

The American Cancer Society can tell you about smoking cessation resources in your community. These may include classes, support groups, Internet resources, or referrals to get help paying for medicine. It is important to have support from many different sources during your quit attempt, including family, friends, doctors, and stop-smoking professionals. Call 1-800-ACS-2345 for more details.

Use Telephone Counseling Programs

You may be able to use a telephone counseling program, such as the American Cancer Society's Quitline^® tobacco cessation program, in your area. You can get quitting strategies and support over the phone, at times that are convenient for you. Telephone counseling programs have been proven to double your chances of successfully quitting. Your state may sponsor a program to stop smoking, or you can enroll in the American Cancer Society's Quitline^® program, or even a clinical trial.

General Tips for Quitting

Here are some general tips to help you try to quit:

• Talk to your doctor, nurse, or pharmacist about which medicines are right for you. 
• Write down your reasons for wanting to quit; keep the list with you for extra motivation. 
• Throw away all of your cigarettes and ashtrays. 
• Substitute the activities you do while smoking with other habits. 
• Set a quit date and plan ahead to help deal with cravings. 
• Tell your family, friends, and co-workers about your plans to quit. 
• Have alternatives to smoking available, such as peppermints, carrot sticks, toothpicks, or cinnamon sticks. 
• Stay busy. 
• Avoid situations that always trigger an urge to smoke. 
• Call your American Cancer Society at 1-800-ACS-2345 for more information, ideas, and resources.

References

Hughes, JR. New treatments for smoking cessation. CA: Cancer J Clin. 2000; 50: 143-151.

Fiore MC, Bailey WC, Cohen SJ, et al. Treating tobacco use and dependence. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service. June 2000. Available at: http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat2.chapter.7644. Accessed October 17, 2007.

Rabius V, McAlister AL, Telch M, et al. Evaluation of the American Cancer Society’s Smokers’ Quitline. Presented at the 129th Meeting of the American Public Health Association, Atlanta, GA. October 2001.

Zhu SH, Anderson CM, Tedeschi GJ, et al. Evidence of real-world effectiveness of a telephone Quitline for smokers. New Engl J Med. 2002; 347: 1087-1093.

Silagy C, Lancaster T, Stead L, Mant D, Fowler G. Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev. 2002; CD000146.

Diefenbacher LJ, Smith PO, Nashelsky J. What is the most effective nicotine replacement therapy? J Fam Pract. 2003;52:492-494.

Jamerson BD, Nides M, Jorenby DE, et al. Late term smoking cessation despite initial failure: An evaluation of bupropion sustained release, nicotine patch, combination therapy, and placebo. Clin Ther. 2001;23: 744-752.

Manufacturer's Product Information. Available at: http://www.pfizer.com/pfizer/download/uspi_chantix.pdf. Accessed October 17, 2007.

Evins AE, Cather C, Culhane MA, et al. A 12-week double-blind, placebo-controlled study of bupropion sr added to high-dose dual nicotine replacement therapy for smoking cessation or reduction in schizophrenia. J Clin Psychopharmacol. 2007;27:380-386.

Revised: 10/23/2007