Medication Guide

This medication guide was created to provide you with a general understanding of the current medications used by smokers who are trying to quit. Please note that this guide may not include every medication available. All of these medications have been shown to be useful for helping smokers quit. There is no one medication that works best for all smokers. Always read the instructions on the package carefully and talk with your doctor or pharmacist if you have questions. The dosing information below is meant only to show how most people use these medications. The dose of your prescription medications must be decided by a doctor. If you are pregnant, breastfeeding, or have a severe medical problem, talk with your doctor before starting any new medication.

First-Line Medications: Nicotine Replacement Therapy (NRT)
These medications are called "first-line" because many smokers use these when they first try to quit. If the first-line medications don’t work, they might try a "second-line" medication instead.

Nicotine replacement therapy (NRT) helps smokers quit by reducing their craving sensations. These craving sensations happen when the body goes through withdrawal from the nicotine in tobacco. NRT products provide controlled amounts of nicotine. Individuals reduce their use of NRT products over time, allowing their bodies to gradually adjust to increasingly lower nicotine levels.
Nicotine Patches Over-the-Counter The nicotine patch is placed on the skin and supplies a small and steady amount of nicotine to the body. Nicotine patches contain varied amounts of nicotine (21 mg, 14 mg, or 7 mg, for example) and the user reduces the dose over time.
Nicotine Gum Over-the-Counter Nicotine gum is chewed to release nicotine that is absorbed through tissue inside the mouth. The user chews the gum until it produces a tingling feeling, then places (parks) it between the cheek and gum tissue. Nicotine gums have varied amounts of nicotine (typically 2 mg or 4 mg) to allow users to reduce the amount of nicotine in their bodies.
Nicotine Lozenges Over-the-Counter Nicotine lozenges look like hard candy and are placed in the mouth to dissolve slowly. The nicotine lozenge (typically a 2 mg or 4 mg dose of nicotine) releases nicotine as it slowly dissolves in the mouth.
Nicotine Inhaler Prescription A nicotine inhaler is a cartridge attached to a mouthpiece. Inhaling through the mouthpiece delivers a specific amount of nicotine to the user.
Nicotine Nasal Spray Prescription Nicotine nasal spray is a pump bottle containing nicotine, which is inserted into the nose and sprayed. Nicotine nasal spray can be used for fast craving control, especially for heavy smokers.
First-Line Medications: Other
Bupropion Prescription Bupropion, also known as Zyban®, helps to reduce nicotine withdrawal symptoms and the urge to smoke. Bupropion can be used safely with nicotine replacement products.
Varenicline Prescription Varenicline, also known as Chantix®, is a prescription medication that eases nicotine withdrawal symptoms and blocks the effects of nicotine from cigarettes if the user starts smoking again.
Second-Line Medications
Nortriptyline Prescription Nortriptyline, also known as Aventyl®, is generally prescribed to treat depression; however nortriptyline has been prescribed to assist with smoking cessation when the first-line medications do not work. The use of nortriptyline for smoking cessation has not been approved by the Food and Drug Administration (FDA).
Clonidine Prescription Clonidine, also known as Catapres®, is generally prescribed to treat high blood pressure; however clonidine may reduce tobacco withdrawal symptoms when first-line medications do not work. The use of clonidine for smoking cessation has not been approved by the FDA.

References: Information in the medication guide and fact sheets is from a variety of sources, such as product information guides; manufacturers’ Web sites, medical Web sites, and articles in the medical literature, including Corelli RL & Hudman KS. Pharmacologic interventions for smoking cessation, Crit Care Nurs Clin N Am 2006;18, 39–51.

DCCPS NCI NIH CDC HHS USA.gov