Nicotine is the most powerful of all addicting substances when looked at from a milligram-for-milligram comparison. It is especially difficult for many people to quit because it has such strong positive reinforcing qualities. We employ a combination of complementary modalities to increase the chance of success.
Pharmacologic support for withdrawal and craving
A wide variety of medications can be used for different aspects of becoming nicotine free. These medications are prescribed on an individual basis, and many patients require combinations of several of them to achieve nicotine abstinence.
Nicotine patches
Different strengths and duration of action are available. The amount of nicotine should be individualized depending on the degree of addiction.
Nicotine gum
Two strengths are available. It can be used alone or as a supplement to other forms of nicotine replacement.
Nicotine inhaler (NICOTROL INHALER®)
This is another form of nicotine substitution and offers a unique delivery system that is similar to the act of smoking itself. Many smokers find the hand to mouth habit very difficult to break, and this method of nicotine replacement effective for some people.
Clonidine (Catapress®)
This is a commonly used medication for high blood pressure, and it blocks a lot of the annoying symptoms of withdrawal that involve adrenaline and the cardiovascular system. It should be used with caution in anyone with low blood pressure. It is available in pills and a patch that releases the medication slowly and continuously over seven days.
Buproprion
The only medication available and approved by the FDA for nicotine craving is Zyban®. It is a long acting preparation of a common antidepressant, buproprion (Welbutrin®). It should not be used by anyone who has had a previous seizure or a medical condition that could predispose to seizures or by anyone who has an active eating disorder.
Chantix (Chantix®)
This is another medical treatment. Available since 2006, it works directly on the nicotine receptor in the brainstem and thus reduces craving and withdrawal. The daily cost is about the same as a package of cigarettes. This is an excellent choice for nicotine substitution failures.
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1860 El Camino Real, Suite 301
Burlingame CA 94010
