Dear NP

Dear NP,

I have been a smoker for over 20 years. I talked to my doctor, and he wants me to take Chantix. What is the safest way to stop? What are the side effects of the different “stop-smoking” medications such as the patch and Chantix? Are there any other alternatives besides drugs?

Dear Reader,

Congratulations on taking steps to stop smoking. It’s not a simple thing to do.

Tobacco cravings and the urge to smoke can be challenging to overcome. Quitting smoking reduces your heart disease, cancer and lung disease risks.

There are currently several methods to quit smoking. The medication varenicline (Chantix) is one option.

Chantix is a pill that works on the craving centers in your brain. This medicine helps block your desire for cigarettes.

As with all medications, there are possible side effects of Chantix. Common side effects include nausea, vomiting and headache.

Some people have reported trouble sleeping and vivid dreams or nightmares. This side effect can be bad enough that people stop taking the medication.

Occasionally Chantix may also cause mood changes. If you notice any suicidal thoughts, depression, agitation or changes in behavior, stop the medicine and contact your healthcare provider right away.

Fortunately, effects like this are rare. Chantix is the most effective medication for smoking cessation. Make sure your healthcare provider knows if you have had seizures, depression or mental illness before taking Chantix.

Bupropion SR (Zyban) is another oral medication commonly prescribed for smoking cessation. Zyban belongs to the anti-depressant class of drugs.

Like Chantix, Zyban helps with cravings for cigarettes. Common side effects of Zyban include dry mouth, nausea, vomiting, sleep problems and rash. You should not take Zyban if you have a seizure disorder or are already taking Wellbutrin for depression.

Nicotine replacement therapy (NRT) is another common method of smoking cessation. NRT is available in patches, gums and lozenges. It is also available without a prescription.

The idea is you use the NRT product to replace cigarettes. Over several weeks, you gradually wean off the NRT.

NRT is very effective. People who use this method boost their quitting success by about 50-70%.

Another well-known method for smoking cessation is “cold turkey.” This method involves abruptly stopping the use of nicotine.

Unfortunately, this method is not very successful. About 95% of people who try to quit this way will begin smoking again.

When you are trying to stop smoking, here are a few other strategies that might help:

Avoid triggers. If you always reach for a cigarette with your coffee or at a party, have a plan of what to do instead of smoking.

Delay urges. If you feel like smoking, try to wait for at least ten minutes. Distract yourself with something else during that time and see if the urge goes away.

Find a substitute. Try chewing gum or eating crunchy food like carrots, celery or sunflower seeds. Give your mouth something to do other than smoking.

Try some physical activity. Exercising can serve as a distraction and reduce cravings. It can even be a short burst, like running in place or going up and down a set of stairs.

Use support systems. Joining an online support group enlisting the help of friends and family members can help you stay strong when cravings hit. 800-QUIT-NOW (800-784-8669) is a free telephone quitline that provides support and counseling.

Remind yourself of the benefits. When you struggle, review why you want to quit.

Writing these down and repeating them aloud can help keep you on track. Your reasons might include feeling better, getting healthier, keeping your loved ones from secondhand smoke and saving money.

The safest way to quit smoking is by using a method that will allow you to succeed with the least amount of side effects. Talk with your healthcare provider about your current habits, health history, and your best option for quitting.

Dr. Wesley Davis is an Emergency Nurse Practitioner at Crook County Medical Services District and Coordinator of the Family and Emergency Nurse Practitioner program at the University of South Alabama. He encourages readers to send their questions to [email protected]