Comparing Quit Smoking Products
May 12th, 2008 | By quitsmoking-review | Category: ProductsIn the current pharmaceutical industry, there are several available quit smoking aids; roughly divided into nicotine replacement products (NRP) and non-nicotine products. The different products/ pharmacotherapies are used to stop smoking and each carrying with it their own pros and cons. The comparison of the different cessation aids are summarized below
| FDA approved medications | Dosing | Prescribing tips | Adverse effects | Costs |
| Nicotine transdermal patch-24-hour release: 7, 14, 21mg patches -16-hour release: 5, 10, 15mg patches Generic Nicoderm 24H Nicotrol 16H Others |
If more than ten cigarettes/day: use full dose. Begin dosing taper after 6 wk | Rotate sites where patch is placed. Prescribe medium potency steroid cream for skin irritation. Use with short-acting NRT | Skin irritation, insomnia. Experts recommend avoidance of use within 2–4 wk after a myocardial infarction, stroke, or unstable angina | $3–$4/day or 2 wk = $48 |
| Nicotine gum | Usual: 2 mg If smoke more than 25 cigarettes a day then use 4-mg pieces. Typical usage: 8–30 pieces/day | Chew until tingle, then “park” between cheek and gum. Caution with dental problems or temporomandibular joint pain syndrome | Jaw pain, excessive salivation, nausea, belching, and hiccups. Experts recommend avoidance of use within 2–4 wk after a myocardial infarction, stroke, or unstable angina | $4–$7/day: Box (108piece) = $47 |
| Nicotine Lozenge 2 mg / 4 mg Commit lozenge | 2 mg. If typically smoke within 30 min of awakening, then use 4 mg. Typical usage is 8–24 pieces/day | Dissolve in mouth over 20–30 min. Do not bite or chew | Headache, nausea, heartburn, flatulence. Experts recommend avoidance of use within 2–4 weeks after a myocardial infarction, stroke, or unstable angina |
$4-$7/day. Box (72 piece) = $32 |
| Nicotine inhaler 4 mg delivered per puff (10-mg cartridge) | 6-16 cartridges/day. Frequent puffs over 20 minutes | Screws into white “tiparillo-like” holder. Resembles cigarette use. Rapid acting | Mouth/throat irritation, cough, headache, nausea, bronchospasm. Experts recommend avoidance of use within 2–4 weeks after a myocardial infarction, stroke, or unstable angina | $5–$12/day Box (168 cartridges) = $137 |
| Nicotine nasal spray 0.5 mg per spray 10-mL bottle (10 mg/mL) sprays. Nicotrol NS | 1–2 spays each nostril. Maximum 10 sprays/hour. Maximum 80 sprays/d | Most potent and rapid acting of NRTs for patients with more serious cravings | Nasal/throat irritation, rhinorrhea, headache, cough, bronchospasm. Experts recommend avoidance of use within 2–4 weeks after a myocardial infarction, stroke, or unstable angina | $5–$13/day. Bottle (200 sprays) = $34 |
| Buproprion SR 150 mg, Zyban, Wellbutrin SR 150 mg | Begin at least 1 week before quit date. Start daily x 3 d, then twice a day | Avoid if seizure risk. Avoid if taking monoamine oxidase inhibitors. Use caution if bulimia, anorexia, alcoholism, history of head trauma present. May use with NRT | 0.1% seizure risk. Insomnia, dry mouth, headache, agitation, caution in the elderly, caution if suicide risk. Experts recommend avoidance of use within 2–4 wk after a myocardial infarction, stroke, or unstable angina |
$3/day for generic |
| Varenicline 0.5 mg, 1 mg. Chantix | Begin at least 1 week before quit date. Start at 0.5 daily x 3 d, then 0.5 mg twice daily x 4 d, then 1mg twice daily | Cannot use with NRT (increased nausea) | Nausea (30%), insomnia/ abnormal dreams, headache, fatigue. Experts recommend avoidance of use within 2–4 wk after a myocardial infarction, stroke, or unstable angina |
$4/day no generic |
Table adapted from the report “The Most Addictive Drug, the most deadly substance: smoking cessation tactics for the busy clinician” by Rob Crane, MD
