How Do Smoking Cessation Aids Work?

Smoking cessation aids are medications that help smokers quit smoking. Smoking cessation aids are usually a part of smoking cessation programs which include behavioral and cognitive techniques to cope with the craving and negative mood states that occur with cessation of smoking, and to prevent relapses.

Smoking cessation aids help reduce withdrawal symptoms such as the urge to smoke, irritability, headaches, anxiety and depression that can occur with smoking cessation. Most smoking cessation medications are nicotine replacement therapies, the first line treatment for smoking cessation.

Nicotine replacement therapies provide controlled amounts of nicotine without the other harmful chemicals in tobacco products, reduce nicotine withdrawal symptoms, and help gradually wean off smoking. Nicotine is the substance that primarily causes addiction to tobacco by stimulating the nervous system and the pleasure centers in the brain.

Nicotine binds to nicotinic receptors, protein molecules on nerve cell (neuron) membranes that respond to nicotine and stimulate the release of mood-elevating neurotransmitters such as norepinephrine and dopamine. Most smoking cessation aids are lower doses of nicotine and work by stimulating the nicotinic receptors.

Two non-nicotine smoking cessation medications that have been approved by FDA to help smoking cessation are:

Varenicline: Varenicline does not contain nicotine, but binds to nicotinic receptors, produces milder effects than nicotine, and reduces its rewarding effects.

Bupropion: Bupropion is an antidepressant drug that increases dopamine and norepinephrine levels in the brain by preventing their reabsorption (reuptake), a normal process in the brain. It is not clear how exactly bupropion works for smoking cessation, but studies suggest it is effective for smokers with or without depression.

Smoking cessation aids are typically used for several weeks to help wean off smoking and prevent relapse. Smoking cessation aids are available over the counter and on prescription in the following forms:

• Oral: Gum, lozenges, tablets and inhalants
• Intranasal: Sprays
• Transdermal: Skin patches

Side effects of smoking cessation aids may include the following:

• Nicotine replacement therapies
• Increase in blood pressure
• Tachycardia (rapid heartbeat)
• Dizziness
• Insomnia
• Irritability
• Headache
• Restlessness
• Cravings
• Impaired concentration
• Emotional lability (mood swings)
• Anxiety
• Somnolence (drowsiness)
• Fatigue
• Confusion
• Increased dreaming
• Depression
• Apathy
• Tremor
• Lack of coordination
• Anorexia (loss of appetite)
• Dyspepsia (indigestion)
• Nausea
• Vomiting
• Flatulence
• Diarrhea
• Increase in appetite
• Weight increase
• Hiccups
• Cough
• Increased salivation
• Increased sweating
• Specific to chewing gum:
  • Sticking to dentures
  • Loosening of dental fillings and inlays
  • Damage to oral mucous tissue and teeth
  • Temporomandibular joint (TMJ) dysfunction and pain with excessive chewing
• Specific to oral inhalation:
  • Mouth and throat irritation
  • Gum problems
• Specific to nasal spray:
  • Nasal irritation
• Specific to transdermal patch:
  • Application site irritation
• Rhinitis (nasal inflammation)
• Sinusitis (inflammation of the sinuses)
• Bronchitis (inflammation of bronchial passage)
• Back pain
• Arthralgia (joint pain)
• Jaw or neck pain
• Migraine
• Taste disturbance
• Tooth abrasions
• Xerostomia (dry mouth)
• Acne
• Dysmenorrhea (painful menstrual periods)
• Cardiac dysrhythmia (irregular and abnormally fast or slow heartbeat), rare
• Tachyarrhythmia (irregular fast heartbeat), rare
• Hypertension (high blood pressure), rare
• Immune hypersensitivity reaction, rare
• Non-nicotine medications
• Nausea
• Abnormal dreams
• Headache
• Insomnia
• Agitation
• Dizziness
• Dry mouth
• Appetite changes
• Weight loss or gain
• Pharyngitis (throat inflammation)
• Sinusitis (inflammation of the sinuses)
• Chest pain
• Palpitations
• Hypertension (high blood pressure)
• Myocardial infarction (heart attack)
• Abnormal EEG
• Arrhythmia (irregular heartbeat)
• Cerebrovascular accident
• Peripheral vascular disease
• Vaginal hemorrhage
• Constipation
• Dyspepsia (indigestion)
• Abdominal pain
• Flatulence
• Gastroesophageal reflux disease (GERD)
• Vomiting
• Diarrhea
• Anorexia (loss of appetite)
• Dyspnea (shortness of breath)
• Upper respiratory tract disorder
• Rhinorrhea (nasal discharge)
• Fatigue or lethargy
• Somnolence (drowsiness)
• Hypersensitivity reactions such as:
  • Rash
  • Pruritus (itching)
  • Erythema (redness)
  • Stevens-Johnson syndrome (a rare medical emergency with flu-like symptoms and a painful rash)
• Infections
• Tinnitus (ringing in the ears)
• Dysphagia (swallowing difficulties)
• Epistaxis (nasal bleeding)
• Anxiety and panic
• Nervousness
• Reduced memory
• Confusion
• Irritability
• Depression
• Mania
• Euphoria
• Psychosis
• Hallucinations
• Delirium
• Delusions
• Paranoia
• Homicidal ideation
• Aggression and hostility
• Suicidal ideation and attempt
• Somnambulism (sleepwalking)
• Tremor
• Ataxia (impaired coordination, balance and speech)
• Paresthesia (abnormal skin sensations)
• Muscle twitch
• Akinesia (difficulty in movement)
• Aphasia (difficulty with language and communication)
• Dysarthria (speech disorder)
• Extrapyramidal syndrome (movement disorders)
• Exacerbation of tardive dyskinesia (a neurological disorder that causes involuntary repetitive movements)
• Seizures
• Coma
• Fever
• Myalgia (muscle pain)
• Arthralgia (joint pain)
• Neuralgia (nerve pain)
• Neuropathy (nerve damage)
• Arthritis
• Migraine
• Sweating
• Flushing
• Frequent urination
• Polyuria (excessive urination)
• Cystitis (bladder inflammation)
• Abnormal liver function test results
• Anemia
• Hyperglycemia (high blood glucose levels)
• Hypoglycemia (low blood glucose levels)
• Hyponatremia (low sodium levels in the blood)
• Syndrome of inappropriate antidiuretic hormone secretion (SIADH, a disorder which causes water retention)
• Increased libido

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

• Aplenzin
• bupropion
• Chantix
• Forfivo XL
• Nicoderm CQ
• Nicorette Gum
• Nicorette Inhaler
• Nicorette Lozenge
• Nicorette Mini Lozenge
• nicotine gum
• nicotine inhaled
• nicotine intranasal
• nicotine lozenge
• nicotine transdermal
• Nicotrol
• Nicotrol Inhaler
• Nicotrol NS
• varenicline
• Wellbutrin SR
• Wellbutrin XL