Smoking cessation

General Information

Giving up smoking may not be easy, but the health benefits are impressive and take effect within just hours or days of quitting. You will also improve the health of people around you by reducing their exposure to second-hand (passive) smoke.

It is beneficial to stop smoking at any age. If you are pregnant, it is vital for your baby’s health that you stop smoking.

Smokers who do not quit have a one in two chance of dying from a smoking-related illness, most commonly lung cancer and other lung diseases, as well as heart disease and stroke.

One reason why people fail to stop smoking, or stay stopped, is being unable to cope with cravings for nicotine. Most people who smoke become addicted to nicotine, and when they stop smoking, they suffer from nicotine withdrawal.

Symptoms of nicotine withdrawal include:

• craving a cigarette
• feeling irritable, anxious or depressed
• headaches
• difficulty concentrating
• difficulty sleeping
• a temporary increase in appetite, and weight gain

Nicotine replacement

Nicotine replacement therapy replaces nicotine without the harmful effects of smoking. Gum and patches are the most commonly used forms. Nicotine replacement therapy can be used to reduce symptoms of nicotine withdrawal and with appropriate support, will make you less likely to start smoking again. The amount of nicotine replacement should be reduced gradually over eight to 12 weeks, so that you are slowly weaned off nicotine.

Nicotine replacement therapy should be used in combination with other strategies to keep you smoke free. These include asking friends and family for support, and avoiding people who may encourage you to smoke.

See Your Pharmacist or Medical Professional

Nicotine replacement products may not be suitable for everyone. Ask for professional advice:

• if you are pregnant or breastfeeding
• if you have high blood pressure, heart or circulation problems or have recently had a stroke
• if you have a thyroid condition
• if you have kidney or liver problems
• if you have stomach ulcers, gastro-intestinal or airway diseases
• if your skin is sensitive to different types of plaster
• if you are a child

Consult your doctor or healthcare professional:

• if you have diabetes and are on insulin; you may need to reduce your dose when you stop smoking
• if you are taking certain other medications, you may also need a change in dose when you stop smoking (this includes some medications for mental health conditions)

Treatment Tips

• it is normal to have a number of attempts to quit smoking
• if one method of quitting smoking does not work, there are others that can be tried which may be more effective
• when you have decided that you would like to quit, set a quit date (ideally within two weeks) and tell all your family, friends and workmates of your plans to quit, and ask for their support. Remove all cigarettes from your home, car and workplace and avoid smoking in these places for two weeks before your quit date
• it is best to stop totally; avoid even a single puff of a cigarette
• plan ahead for situations where you would have previously smoked
• know how to deal with cravings when they occur; do something else, such as drinking water and deep breathing. Cravings generally only last a few minutes
• have a supply of nicotine replacement therapy on hand at all times, to avoid the temptation of having a cigarette
• nicotine-free therapy, hypnosis and acupuncture may be useful strategies for quitting smoking; discuss your options and plans with your healthcare professional
• talk about your progress or problems with family, friends and your pharmacist or doctor. Regular contact with health professionals (such as buying your smoking cessation products weekly) may help you quit
• for further advice and support, phone Quitline on 137 848
• if you still find it hard to quit, your doctor may be able to prescribe medicine to help

Treatment Options

Nicotine replacement therapy

• nicotine replacement therapy is available as gum, patches, lozenges, tablets and inhalers 
• the strength or amount of the product you should use depends on the number of cigarettes you smoke. Your healthcare professional may ask you some questions to assess your nicotine dependence level, such as time to first cigarette and number of cigarettes smoked per day
• gradually reduce the strength or amount of nicotine replacement product you use, according to the manufacturer’s directions and your needs
• you should not use nicotine replacement products if you are only an occasional smoker. Your healthcare professional will be able to help you with support strategies in nicotine-free therapy

Chewing gum, patches, lozenges, tablets (nicotine replacement)

[GENERAL SALE]
e.g. Nicabate Gum, Nicabate Lozenges, Nicabate Mini Lozenges, Nicabate patches, Nicorette Chewing Gum, Nicorette Microtab, Nicorette Patch, Nicotinell Chewing Gum, Nicotinell Patch

Chewing gum

• nicotine gum can be used when you quit smoking completely, or it can be used to help gradually reduce the number of cigarettes you smoke
• nicotine gum can also be used in combination with nicotine patches. This may be a more effective option for certain people; discuss this with your pharmacist
• it is important to use the correct chewing technique; it is not chewed continuously like normal chewing gum. Check the pack details for more information or speak to your health professional
• food and drink should be avoided while the gum is in the mouth
• nicotine replacement gum may not be suitable for people with dentures or some types of dental work

Patches

• smoking should be avoided while a patch is on; however, a new ‘pre-quit’ patch can be used for 2 weeks while smoking to reduce anxiety associated with quitting abruptly
• patches supply a steady amount of nicotine into the body, which reduces cravings for cigarettes
• apply the patch to a hairless part of the body; use a different area of skin each day
• after removing the patch, fold the sticky ends together and dispose of it carefully; even used patches can contain enough nicotine to poison a child or pet
• nicotine gum or inhalers can be used in combination with patches if you still have cravings, despite using the correct strength patch; see your pharmacist for more information
• there are two different types of patches: those that you remove before bed and those that you keep on for 24 hours. Discuss these options with your pharmacist

Lozenges

• nicotine lozenges should be used when you quit smoking completely
• move the lozenge around the mouth from time to time until it dissolves (do not chew or swallow the lozenges)
• food and drink should be avoided while the lozenge is in the mouth

Tablets

• Nicorette Microtabs should be placed under the tongue and allowed to dissolve in the mouth (do not chew or swallow the tablets)

Inhalers (nicotine replacement)

[PHARMACY ONLY]
e.g. Nicorette Inhaler

• nicotine inhalers can be useful for people who miss holding a cigarette
• they can be used when you quit smoking completely or they can be used to help gradually reduce the number of cigarettes you smoke

Nicotine-free therapy

[GENERAL SALE]
e.g. Nicobrevin capsules

• Nicobrevin contains a combination of 4 ingredients (menthyl valerate, quinine, camphor and eucalyptus oil) that may help reduce cravings and other nicotine withdrawal symptoms
• Nicobrevin is taken as a 28-day course, on an empty stomach (without food) with a gradual reduction in dose

[PRESCRIPTION ONLY]
e.g. bupropion (Zyban SR), varenicline (Champix)

• these medicines help to decrease the craving for cigarettes
• people start taking these medicines while still smoking and have a target stop date after one or two weeks of treatment.
• they should not be used in conjunction with nicotine replacement therapy

More Information

Also see www.quit.org.au or www.quitnow.info.au for information on the effects of smoking and tips for quitting.

Availability of medicines

• GENERAL SALE available through pharmacies and possibly other retail outlets.
• PHARMACY ONLY available for sale through pharmacies only.
• PHARMACIST ONLY may only be sold by a pharmacist.
• PRESCRIPTION ONLY available only with a prescription from your doctor or other health professional.

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myDr, 2009
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Last Reviewed: 08 February 2010