Smoking Cessation

There are many benefits to quitting smoking including improved physical appearance, cardiopulmonary function, immune system, hormone levels, bone/muscle structure, recovery from injury or surgery, and obviously a decreased risk of cancer. Despite the benefits, giving up smoking cigarettes is not an easy task, as addiction and physical dependence are in full swing. The most important determinants in successful detoxification and maintenance are the person’s willingness to accept that he/she is addicted to and/or physically dependent on nicotine and that he/she has made the decision to quit smoking on his/her own accord. Adherence to a plan for controlling cravings and participation in a support group may aid in the process. Setting a definitive quit date also helps in working towards this goal.

Certain medications are used in conjunction with the above process. Varenicline interferes with nicotine receptors in the brain, thereby lowering the reward pathway derived from smoking and making withdrawal more tolerable. Adverse effects most commonly include nausea, headache, insomnia, constipation, stroke, heart attack, and seizures. Bupropion is categorized as an atypical antidepressant and helps to reduce nicotine craving and withdrawal. It also alters the flavor of cigarettes, making them taste poorly. Nortriptyline is another antidepressant that helps to reduce nicotine withdrawal. Adverse effects are covered in the antidepressant section of this website. Clonidine is a blood pressure medication that also may help reduce nicotine withdrawal. Adverse effects most commonly include low blood pressure, low heart rate, fainting, dizziness, drowsiness, dry mouth, and constipation. All of these medications must be tapered slowly to prevent serious adverse effects.