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Nicotine addiction and withdrawal - Treatment

Alternative Names

Withdrawal from nicotine; Smoking - nicotine addiction and withdrawal; Smokeless tobacco - nicotine addiction; Cigar smoking; Pipe smoking; Smokeless snuff; Tobacco use; Chewing tobacco

Treatment:

There are several strategies for treating nicotine withdrawal.

Nicotine supplements can help. All of them work well, if used properly. See: Nicotine replacement therapy

Nicotine supplements come in several forms:

  • Gum
  • Inhalers
  • Nasal spray
  • Skin patch

Nonhabit forming prescription medications may help you quit smoking and keep you from starting again. See: Smoking cessation medications

Such medicines include:

  • Bupropion (Wellbutrin, Zyban)
  • Varenicline (Chantix)
  • Other medications, including clonidine, antidepressants such as nortriptyline or fluoxetine (Prozac), and buspirone (Buspar) have shown some benefits, but are not FDA-approved for smoking cessation

Like any addiction, quitting tobacco is difficult, especially if you are acting alone. If you join a smoking cessation program, you have a much better chance of success. See: Stop smoking support programs

  • Smoking cessation programs are offered by hospitals, health departments, community centers, and work sites.
  • The best quit-smoking programs combine many strategies to help keep you from starting smoking again. Counseling by telephone can be as helpful and as effective as face-to-face counseling.

Untreated depression can prevent you from quitting tobacco. A screening test for depression may help ensure proper treatment and increase the odds that you will stay off tobacco products.

People who are trying to quit smoking often become discouraged when they don't succeed at first. Research shows that the more times you try, the more likely you are to succeed -- so don't give up! If you aren't successful the first time you try to quit, look at what worked or didn't work, think of new ways to quit smoking, and try again. Many attempts are often necessary to finally "beat the habit." See: Smoking - tips on how to quit

Expectations (prognosis):

Nicotine withdrawal is short-lived and symptoms pass in time, usually in less than a week. Withdrawal is the most uncomfortable part of quitting, but the real challenge is beating long-term cravings and staying away from tobacco.

Complications:

Long-term use of nicotine products, whether smoking or using smokeless tobacco products, carries many risks, including:

  • Cancer
  • Heart disease
  • Pregnancy problems
  • Stroke

See: Making the decision to quit tobacco

Weight gain due to increased eating also may occur. This is much less unhealthy than continuing to smoke. People who have concerns about their weight should address them while quitting, so these concerns do not affect their attempts to stay away from cigarettes.

Nicotine withdrawal may also bring on a relapse of major depression, bipolar disorder, or other substance abuse problems.

Calling your health care provider:

See your health care provider if you wish to stop smoking, or have already done so and are experiencing withdrawal symptoms. Your provider can help provide treatments, some of which are only available by prescription.

  • Reviewed last on: 10/31/2010
  • David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, Unviersity of Washington, School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Benowitz NL. Tobacco. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 30.

Burke MV, Ebbert JO, Hays JT. Treatment of tobacco dependence. Mayo Clin Proc. 2008;83:479-483.

Hays JT, Ebbert JO, Sood A. Treating tobacco dependence in light of the 2008 US Department of Health and Human Services clinical practice guideline. Mayo Clin Proc. 2009;84:730-735.

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