Quit-smoking medicines roughly double or triple your chances of quitting for good. Yet most people who try to quit use none. Here is how the main options compare.
Varenicline (formerly sold as Chantix)
The most effective single medicine. It partly activates nicotine receptors, easing cravings, and blocks nicotine from them, so smoking feels less rewarding. You start a week before your quit date, or quit gradually over a few weeks while taking it, and continue for 12 weeks, often longer. Nausea and vivid dreams are the most common side effects; taking it with food and a full glass of water helps. The brand Chantix was pulled in 2021 over an impurity, but generic varenicline is widely available. The FDA removed its boxed warning about psychiatric side effects in 2016 after a large safety study.
Nicotine replacement
Patches, gum, lozenges, inhalers and nasal spray supply nicotine without the smoke. The most effective way to use them is combination therapy: a daily patch for steady levels plus gum or lozenges for breakthrough cravings. Patches, gum and lozenges are available without a prescription.
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Primary care, mental health, and addiction medicine in one practice. New patients are often able to be scheduled within a week of requesting an appointment.
Bupropion SR (Zyban, Wellbutrin SR)
An antidepressant that also reduces cravings and limits weight gain after quitting. Start one to two weeks before the quit date. It is a good choice when depression is also present, but not for people with seizures or eating disorders.
Combinations
Varenicline with nicotine replacement, or bupropion with nicotine replacement, can help heavy smokers or people who have relapsed before.
Coverage
Most insurance plans cover quit medicines as preventive care, and the South Carolina Tobacco Quitline, 1-800-QUIT-NOW, offers free coaching and often free nicotine replacement.
Get help from Hope Integrative Medicine
Our primary care team can choose the right quit medicine with you, check for interactions and follow up as you go, in person in West Ashley or by telehealth across South Carolina. New patients are often able to be scheduled within a week of requesting an appointment. Request an appointment.
This article is general health information and does not replace advice from your own provider. Never start, stop or change a medication without talking with your prescriber.
Frequently Asked Questions
Varenicline is the most effective single medicine. Combination nicotine replacement, a patch plus gum or lozenges, is about as effective, and bupropion is another option.
The brand Chantix was pulled in 2021 over an impurity, but generic varenicline is widely available and works the same way.
Yes. Combining a daily patch with gum or lozenges for breakthrough cravings works better than either alone.