Quit Smoking Treatment

There are a range of treatments and techniques available to help you quit smoking, such as prescription medication, nicotine replacement therapy (NRT), and e-cigarettes. You can also get further advice and support from your GP or local quit smoking service.

Prescription medication

There are currently 2 prescription medications available in the UK to quit smoking: Zyban and Cytisine. Champix is also a prescription stop smoking medication but it’s currently unavailable in the UK and it’s not known whether it’ll be available again in the future.

Zyban – Zyban contains the active ingredient bupropion hydrochloride, which is also an antidepressant. Zyban affects the parts of your brain responsible for cravings and addiction, making it easier to manage cravings and withdrawal symptoms when you quit. It also makes smoking less enjoyable if you smoke during treatment. It works best after taking it for a few days.

Zyban is taken over 7 to 9 weeks, after which you should stop taking it. The usual dosage is 1 or 2 tablets daily. In clinical studies, bupropion was found to help 52 to 77% more people quit smoking for 6 months or more compared to a placebo.

Cytisine – Cytisine is a new stop smoking medication. Each Cytisine tablet contains 1.5mg of the active ingredient cytisine. It works in a similar way to Champix, reducing the urges you get to smoke by attaching itself to some of the same receptors in your brain that nicotine does (the drug in tobacco that makes it addictive). This makes it easier to quit, especially at the start. It works within a couple of hours.

According to clinical trials, Cytisine was found to help 59% more people abstain from smoking during treatment compared to those who took a placebo. Cytisine is taken over a 25-day course, with the number of tablets you take gradually decreasing. On the first 3 days, you’ll take 1 tablet every 2 hours, with a maximum daily dose of 6 tablets. By day 21, you’ll reduce your dose to 1 or 2 tablets a day.

Champix – Champix is no longer available in the UK. It was withdrawn as a precaution, as it was found to contain an impurity. We aren’t sure if it’ll become available again in the future.

Champix contains the active ingredient varenicline which imitates the effect of nicotine. It works by stimulating the receptors in the brain that respond to nicotine, so you’ll get fewer withdrawal symptoms. This makes it easier to stop smoking altogether.

You begin taking Champix a week before you want to stop smoking. This gives it a chance to build up in your body, so that by the time your body starts to feel withdrawal symptoms, Champix has already taken effect.

Nicotine replacement therapy (NRT)

NRT products contain nicotine without the added harmful chemicals of a cigarette. They can reduce withdrawal symptoms by providing your body with nicotine. NRT can be bought over the counter from pharmacies, supermarkets, and some other stores. They can also be prescribed by your doctor or stop smoking clinician. In a clinical trial, NRT was found to help 50 to 60% more people quit smoking compared to those who didn’t take anything.

NRT comes in 2 forms, it’ll either work immediately (fast-acting) or within a few hours (slow-release). It’s best to combine both types to improve your chances of quitting.

As NRT contains nicotine, it can also be addictive. It's important to stop using NRT gradually.

You may not be able to use NRT alongside certain stop smoking prescription medications, especially if you have other health conditions. Speak to your doctor if you want to use NRT and are taking medication.

E-cigarettes

E-cigarettes, also known as vapes, are electronic devices that can help you quit smoking. They contain nicotine at different strengths, but have been found to be less harmful than cigarettes in clinical trials.They do still contain chemicals and longitudinal studies (studies over years or decades) have yet to be carried out into their safety and health risks for long-term users.

E-cigarettes work by replacing the nicotine you’d have from cigarettes and mimicking the hand-to-mouth habit of smoking, which can help with withdrawal symptoms and cravings. For quitting smoking, they should be gradually decreased in strength until you stop taking nicotine altogether.

According to an NHS review, people who used e-cigarettes to stop smoking alongside support from a quit smoking clinician were twice as likely to quit compared to those using NRT.

E-cigarettes still contain nicotine, which is an addictive substance. You should try to gradually reduce how often you use your e-cigarette and the nicotine strength of your vape liquid.

There are many benefits to quitting smoking, such as:

• easier breathing and reductions in breathing problems
• improved lung health
• younger and brighter looking skin, as more oxygen can get to your skin and you’re no longer inhaling harmful chemicals
• improved tooth health
• less staining on the teeth from tar
• less chance of dying younger due to a smoking-related disease
• more energy
• improved fertility (if you’re trying for a baby, your doctor may recommend quitting)
• a stronger immune system
• decreased stress and anxiety levels, as nicotine can increase both of these in the long-term, even if it provides short-term relief
• improved sense of taste and smell
• better blood circulation, which can improve heart and muscle health and make it easier to do physical activity
• a smaller risk of developing a range of health conditions, such as bone disease, eye disease, dementia, and type-2 diabetes
• being a role model for your children (teenagers who have a parent or caregiver that smokes makes them 4 times more likely to start smoking)
• protecting others from secondhand smoke
• saving money (as of December 2023, the average price of 20 cigarettes is £15.67, which adds up to £5719.55 a year if you’re a heavy smoker who smokes one pack a day)

Quitting smoking will also reduce your risk of smoking-related diseases and death:

• After 1 year your risk of a heart attack decreases by half compared to someone who still smokes.
• After 10 years, your risk of lung cancer death decreases by half compared to someone who still smokes.

After 15 years, your risk of heart attack will be the same as someone who’s never smoked.

When you quit smoking, you’ll get withdrawal symptoms and crave cigarettes. These are strongest in the first few weeks and can last a few months, but will gradually get easier to manage. Withdrawal symptoms and cravings can be managed with prescription medications, NRT, e-cigarettes, and other techniques.

Common withdrawal symptoms when you quit smoking include:

• a change in mood, including irritability, anger, sadness, and anxiety
• feeling jumpy and restless
• difficulty concentrating
• difficulty falling and staying asleep
• feeling hungrier, which can lead to weight gain
• headaches
• nausea (feeling sick)
• feeling generally unwell

There are 2 different types of cravings you can get after you quit smoking, which are:

• A background craving for a cigarette that doesn’t go away – this tends to get better within a few weeks to a few months.
• A sudden and immediate need for a cigarette – this is usually triggered by something, such as a social event where everyone goes outside to smoke, or due to strong emotions, such as stress. You’ll start to notice that certain people, smells, sounds, or places can trigger an immediate craving, so it’s best to avoid these where you can, although this isn’t always possible.

How can I manage withdrawal symptoms?

You can manage your withdrawal symptoms and cravings in several ways, such as:

• using prescription medication, NRT, or an e-cigarette
• getting advice and support from a stop smoking clinician
• speaking to family and friends
• removing the temptation to smoke by getting rid of any cigarettes in the house
• using techniques to distract or calm your mind, such as deep breathing
• using something that can keep your hands busy when you’re craving a cigarette, such as fidget toy
• reminding yourself why you’re quitting

Managing different withdrawal symptoms

If you’re feeling irritable or anxious, try doing something that makes you happy or helps you to relieve stress, such as running, dancing, or yoga.

If you’re feeling jumpy or restless, reduce your caffeine intake, especially before bedtime. When you stop smoking it can impact how your body responds to caffeine, so it could feel stronger or the effects can last longer than they did before. This is because nicotine changes your body's ability to absorb and utilise caffeine.

If you’re feeling hungrier than usual, try to snack on low-calorie, healthy options or use something to keep your mouth busy, such as chewing gum.

If you have trouble falling asleep, don’t use a 24-hour nicotine patch. You can also look at ways to improve your sleep habits, such as removing electronics an hour before bed or making the room darker and more comfortable for sleep.

How long will withdrawal symptoms last?

Withdrawal symptoms are strongest in the first few weeks. As the weeks go by, your withdrawal symptoms should lessen until they eventually go away altogether, although this can take several months.

When will I stop craving cigarettes?

This is different for everyone, but most people have fewer cravings once withdrawal symptoms start to get better. You may never fully stop craving cigarettes, but it’s most likely to happen every now and then, rather than all the time. It’s usually situational, such as going out with a friend who smokes, even if months have passed since you thought about cigarettes.

Some people stop craving cigarettes altogether after they’ve stopped smoking for several months or more. You may find that you no longer enjoy the smell or taste, or that they make you feel nauseous.

Yes, like all medications, prescription stop smoking medication can cause some side effects. This isn’t likely to be long-term, as you only take prescription stop smoking medication for a few weeks or a few months, depending on the treatment. Side effects are most likely at the start of your treatment, but it may be difficult to tell whether this is a side effect of the medication or a withdrawal symptom.

If your side effects don’t go away or get better within a few weeks of taking your treatment, speak to your doctor or stop smoking clinician. If you get serious or severe side effects, call 111 or 999 in an emergency.

Zyban side effects

Most common side effects of Zyban include:

• difficulty falling asleep – it’s best to avoid taking your treatment near bedtime
• feeling depressed, anxious, or agitated
• difficulty concentrating
• feeling shaky
• headache
• nausea
• vomiting (being sick)
• stomach pain
• constipation
• changes in taste
• dry mouth
• fever
• dizziness
• sweating
• skin rash
• itching

For a full list of all Zyban side effects, please read the patient information leaflet.

Cytisine side effects

Most common side effects of Cytisine include:

• change in appetite (mainly an increase)
• weight gain
• dizziness
• irritability
• mood changes
• anxiety
• high blood pressure
• dry mouth
• diarrhoea
• rash
• fatigue
• sleep disorders (insomnia, drowsiness, lethargy, abnormal dreams, nightmares)
• headaches
• increased pulse
• nausea
• changes in taste
• heartburn
• constipation
• vomiting
• abdominal pain (especially the upper abdomen)
• muscle pain

For a full list of all Cytisine side effects, please read the patient information leaflet.

Champix side effects

Most common side effects of Champix include:

• inflammation of the nose and throat
• abnormal dreams
• difficulty sleeping
• headache
• nausea

For a full list of all Champix side effects, please read the patient information leaflet.

You should not use any prescription stop smoking medication without the help of a doctor or stop smoking clinician. They will check your medical history and current medications to make sure it’s safe and suitable for you to take. You should also speak to a doctor before using NRT or e-cigarettes.

If you’re taking a prescription medication to stop smoking, you may not be able to use NRT. For example, taking Zyban and nicotine patches can cause your blood pressure to become too high, so you may need weekly check-ups. Speak to your doctor before using NRT if you’re taking Zyban, Cytisine, or Champix.

You should not use stop smoking treatment if you:

• have an allergy to any of the ingredients
• are under 18, unless your doctor has told you otherwise
• do not smoke

Zyban is not suitable if you:

• have a mental health condition, such as anxiety, depression, bipolar disorder, or an eating disorder
• have epilepsy
• are pregnant or breastfeeding

Cytisine is not suitable if you:

• have unstable angina
• have recently had a heart attack or stroke
• are pregnant or breastfeeding
• have clinically significant arrhythmias (an irregular or abnormal heart rhythm)

If you use oral contraception, such as the combined contraceptive pill, you should use a secondary barrier method whilst taking Cytisine because its impact on the effectiveness of the pill is not yet known.

Can I use NRT while pregnant or breastfeeding?

NRT is safe for most people, but check with your doctor first, especially if you are:

• under 18
• pregnant – you may be able to use NRT if your doctor thinks it’ll help you quit
• breastfeeding – your doctor or midwife will explain how to take this safely

To improve your chances of quitting smoking you can:

• stay active – this improves your mood, distracts your mind when you get cravings or withdrawal symptoms, and will reduce the chance of weight gain
• get extra support from your doctor, a stop smoking service, a private therapist, or the NHS stop smoking helpline
• make a list of the reasons you are quitting and read through them when you’re struggling with cravings
• create a self-help plan for when you feel tempted to smoke, such as doing something that makes you feel good or talking to a friend
• get support from family and friends
• start a healthy diet – this can reduce weight gain and improve your physical and mental health
• identify things that trigger your cravings and try to avoid them, such as a certain place, until you feel like you can manage them
• reduce the amount of time you spend around other smokers – if you live with other people that smoke, ask them if they can avoid smoking around or near you
• join a support group in your area or on social media
• start a new hobby or learn a new skill
• create a savings account and put in the money you’d usually spend on cigarettes – this can be a great motivator and can be put towards something special for yourself or your family