Smoking Cessation Treatment Options
The U.S. Food and Drug Administration (FDA) has approved five medications to help you quit smoking:
- Bupropion SR (brand name Zyban®)—available by prescription
- Nicotine gum—available over-the-counter
- Nicotine inhaler—available by prescription
- Nicotine nasal spray—available by prescription
- Nicotine patch—available by prescription and over-the-counter
The most effective treatment method is the dual-medicine approach—using a combination of bupropion and a nicotine-replacement product.
Zyban® (bupropion)
In 1997, the U.S. Food and Drug Administration approved Zyban® as the first non-nicotine medication to treat nicotine dependence. Zyban® is not really new. It is actually the same compound as the popular antidepressant Wellbutrin®.
Zyban® is the first non-nicotine treatment that is superior to nicotine replacement in helping smokers stop smoking and in reducing relapse. Zyban® also appears to prevent weight gain and depression associated with smoking cessation. The length of treatment will vary depending on a person’s mood, withdrawal and craving.
All drugs of abuse, including nicotine, cause a dopamine surge and subsequent depletion in the brain’s reward pathway.
Zyban® is thought to lessen nicotine craving by blocking dopamine from being recycled too quickly (inhibiting re-uptake), thereby increasing the availability of dopamine along the brain’s reward path.
Zyban® also is thought to reduce anxiety and agitation associated with withdrawal by calming down the noradrenergic activity in an area of the brain called the locus coeruleus.
Studies indicate that Zyban® is both safe and effective in decreasing the urge to smoke and in helping people abstain from smoking.
Using Zyban® in combination with nicotine-replacement therapy is more effective than using the nicotine-replacement system alone. This dual-medicine approach—utilizing nicotine replacement to block withdrawal symptoms in combination with Zyban® to reduce craving and stabilize mood—is an effective treatment strategy.
Nicotine-replacement therapy
There are several types of over-the-counter nicotine-replacement products, including patches, gum, nasal spray and inhaler. They are all about equally effective; about 28 percent of smokers who use them successfully quit. The key is to find the right approach for you. Some smokers like to play with the inhaler like they would a cigarette. For others, feeling the spray in the back of their throat is rewarding.
By Drew Edwards, MS; Mark S. Gold, MD
© 1999 University of Florida McKnight Brain Institute
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