Smoking cessation is a hard-won goal for millions of smokers across the globe. The extremely addictive nature of nicotine makes attempting to quit an unpleasant and difficult process. Thankfully, several methods have been found to aid with this. Specifically, finding a medical treatment to quit smoking has become more scientifically backed and readily available than before. But what are these medical options, and how do they work?
For many smokers eager to quit, medical treatments have the advantage of offering a concrete and direct link to the physical, bodily processes that play a role in their addiction. Current smoking cessation medical treatments also offer a variety of approaches in an effort to work with each individual smoking addict’s strengths and to address their personal challenges on their way toward a successful recovery.
That said, before delving into medical treatment options that include psychopharmacology and medical devices, certain non-invasive options also warrant one’s attention. Studies have shown that both behavior-focused psychotherapy and hypnosis can help facilitate smoking cessation. As a result, those considering starting treatment for their addiction to cigarettes should also consider these approaches.
At present several smoking cessation medical treatments offer empirically proven results:
Two prescription medications have been approved by the FDA for their ability to ease the severity of the nicotine withdrawal process. Both work to decrease the unpleasant symptoms of nicotine withdrawal, each in its own way. Unlike nicotine replacement products that will be discussed later, neither of these medications contain doses of nicotine. Both medications can usually be combined with other smoking cessation treatment options.
Bupropion (which is sold under the brand name Wellbutrin) is an antidepressant whose slow-release formulation is FDA-approved \to treat smoking addiction. It is believed to reduce nicotine withdrawal symptoms by causing the release of other chemicals, which act as a counterbalance to the adverse effects of withdrawal. These chemicals include the neurotransmitter dopamine, which at higher doses can cause a pleasant sensation (hence its use as an antidepressant). Since dopamine has also been shown to increase one’s energy levels, bupropion can help negate the weight gain that often occurs during the smoking cessation process. Side effects of bupropion include headaches, insomnia, and dry mouth. This medication is not recommended for individuals who suffer from seizures.
Varenicline (which is sold under the brand name Champix), helps prevent nicotine dependence by blocking nicotine receptors in the brain, thereby preventing the pleasurable effects that tobacco inhalation is known to cause. Its side effects include insomnia, nausea, and strange, vivid dreams.
Deep Transcranial Magnetic Stimulation (Deep TMS) has been FDA-cleared to facilitate smoking cessation since August 2020. A non-invasive medical device treatment, Deep TMS works by utilizing electromagnetic pulses that help regulate the neural activity of brain structures associated with smoking addiction. Over time, Deep TMS has been shown to reduce the cravings associated with nicotine withdrawal, allowing for a more manageable cessation process.
Deep TMS is considered a very tolerable treatment that generally does not cause any long-lasting or significant side effects. It also does not necessitate the use of anesthesia, allowing it to be incorporated into the patient’s daily routine. It can be combined with types of treatment, such as medication, nicotine replacement therapy (which will be elaborated on further down), and psychotherapy.
In addition to smoking addiction, Deep TMS has been FDA-cleared as a safe and effective treatment for major depressive disorder (MDD) and obsessive-compulsive disorder (OCD). It has further received the European CE-mark status, as a safe option for these and additional mental health and neurological conditions.
Nicotine replacement products rely on the release of smaller doses of nicotine, compared to nicotine products such as cigarettes. The advantage of such products lies in their ability to work with the activated nicotine withdrawal process, gradually weaning it off its established nicotine dependence. Many smokers find this method to be more effective, and choose to use nicotine replacement products during the cessation process, either on their own or as a supplementary option that works in tandem with medication or Deep TMS.
Several types of nicotine replacement products are currently available on the market: They are:
Nicotine patches, which are placed on the skin to allow the body to absorb the nicotine they release. Patches are available at different doses, which can fit recovering smokers at different stages of the cessation process. However, since nicotine patches should be replaced every 24 hours, they may not always meet the more immediate appearance of various withdrawal symptoms. Side effects of nicotine patches can include insomnia and vivid dreams.
Nicotine gum is another replacement option, whose nicotine is absorbed through the lining of one’s mouth. It is available without a prescription at two different doses, and unlike nicotine patches, can be used to adjust quickly to cravings or other fluctuating withdrawal symptoms. Side effects of nicotine gum include jaw pain, as well as mouth irritation, heartburn, and nausea.
Nicotine lozenges offer a similar sense of relief to gum, but without causing jaw pain. They can, however, cause mouth irritation, heartburn, and nausea.
Nicotine inhalers provide nicotine in vapor form that enters one’s bloodstream through the lining of their mouth and throat. It too, can offer different doses and can help with sudden cravings. Unlike lozenges and gum however, inhalers are only available by prescription. Side effects include mouth and throat irritation. Nicotine inhalers are usually not recommended for individuals dealing with a breathing condition, such as asthma.
Finally, there are nicotine nasal sprays. These provide nicotine that is absorbed through one’s nose lining. While they work faster than other nicotine replacement products, nicotine sprays are only available via prescription. Side effects include nasal and throat irritation, rhinitis, eye watering, coughing, and sneezing. Nicotine nasal sprays are not recommended for those dealing with nasal or sinus issues.