Your Guide to Medications That Can Help You Quit Smoking

Varenicline (Chantix) is a smoking cessation medication designed to help reduce nicotine cravings and withdrawal symptoms, making it easier to quit.

The drug selectively binds to receptors in the brain that mediate dopamine release, which are believed to be the major receptors involved in tobacco use disorder. It also competitively blocks the binding of nicotine, so even if you do smoke, you won’t feel as much of an effect.

Side effects of varenicline may include:

• nausea
• vomiting
• upper respiratory issues
• drowsiness
• fatigue
• headache
• dizziness
• constipation
• insomnia
• mood changes
• unusual dreams

In rare cases, varenicline can lead to more serious side effects, such as seizures, chest pain, or changes in heart rate. If you already take varenicline and experience these side effects or worsening of other side effects, contact a healthcare professional.

Varenicline is not suitable for everyone, including people who:

• have a history of mental health conditions
• are pregnant or nursing
• have severe kidney conditions
• have a history of seizures or other neurological conditions
• take certain medications, including anticonvulsants, antibiotics, and antidepressants

In June 2021, Pfizer halted production of Chantix due to the presence of high levels of nitrosamines. These are chemicals that can increase your risk of cancer.

While the brand name Chantix has been fully discontinued, FDA-approved generic versions are still available. The generic drugs meet nitrosamine requirements.

Bupropion (Zyban, Wellbutrin) is an atypical antidepressant that’s also prescribed to help people quit smoking. It works by affecting dopamine and norepinephrine, which are neurotransmitters involved in the pleasure and reward aspects of smoking. In this way, it helps reduce craving and withdrawal symptoms.

A 2020 research review found that people who took the antidepressant bupropion were 52% to 77% more likely to fully quit smoking. However, some people experienced mental health symptoms, causing them to stop taking the medication.

Bupropion may also reduce the pleasurable effects of nicotine, making it easier for you to quit and reducing the likelihood of returning to smoking.

Side effects of bupropion may include:

• dry mouth
• headache
• anxiety
• nausea
• insomnia
• agitation
• constipation
• dizziness
• rash

Less common side effects of bupropion include seizures and changes in heart rate or rhythm.

Bupropion is not for those with:

• seizure disorders (bupropion can increase the risk of seizures)
• alcohol use disorder
• anorexia nervosa or bulimia nervosa
• heart disease
• history of allergic reaction to bupropion or any of its components

You’ll also want to skip bupropion if you’re pregnant or nursing.

In addition to bupropion, other antidepressants may have potential use for smoking cessation.

In particular, nortriptyline (Pamelor) is sometimes prescribed if other medications or approaches haven’t worked. Nortriptyline is a tricyclic antidepressant that affects a number of neurotransmitter systems. It primarily blocks the reuptake of norepinephrine, with a lesser effect on serotonin.

Potential side effects of nortriptyline include:

• nausea
• drowsiness
• changes in appetite
• fatigue
• anxiety
• nightmares
• dry mouth
• constipation
• difficult or frequent urination
• changes in sex drive

Experts are also looking into the potential for other antidepressants to help with smoking cessation, but there’s currently not enough evidence to support their use.

While not strictly a medication, nicotine replacement therapy (NRT) is sometimes used alongside smoking cessation medications.

NRT involves the use of products that provide a lower dose of nicotine than what you’d typically get from cigarettes (or other tobacco products). This lower dose can ease the transition from smoking to complete abstinence by reducing withdrawal symptoms and curbing cravings.

NRT comes in several forms including the following:

• gum
• transdermal patch
• nasal spray
• inhaler
• sublingual tablets or lozenges

NRTs have been found to be relatively helpful for quitting smoking. A 2018 review of 133 studies found that all forms of NRT can increase the rate of quitting by 50% to 60%.

Before starting a smoking cessation product, be sure to talk with a healthcare professional or a smoking cessation specialist to determine which approach is the best fit for you.

Here are a few things to consider before choosing a smoking cessation medication or product:

• Nicotine dependence: If you’re highly dependent on nicotine, you may prefer a product that provides a higher dose of nicotine, such as a nicotine patch or lozenge.
• Medical conditions: It’s important to discuss any medical conditions, such as high blood pressure or heart conditions, with your doctor before starting a smoking cessation product. Some products may interact with medical conditions or medications.
• Personal preference: It’s important to choose a product that works for you. For example, one person may prefer a gum or lozenge because it lets them manage the dose of nicotine, while another person may prefer a patch because they don’t have to think about it as often.

In some cases, you can use more than one type of smoking cessation product (such as the patch and gum). Some evidence suggests that using two NRTs together is more likely to help you quit than using one alone.

Still, it’s important to follow the recommended usage instructions for each product and to monitor for any side effects or adverse reactions.

Quitting smoking is a major step toward better health, but it’s easier said than done. Smoking cessation medications can help you get over the final hump and quit for good.

If you want to quit smoking and think a smoking cessation product or medication can help you take that step, be sure to discuss it with your healthcare professional first to determine the best fit for you.