Quit the Habit – For Good: Getting Pharmaceutical Help

Excela Health Smoking Cessation Program
Presented by Dr. Abigail Casey

Once you’ve decided to quit smoking, it’s a good idea to talk to your doctor about medications to minimize your withdrawal symptoms, in order to make it a successful quitting process.
There are a number of reasons smoking is addictive, and thus why it’s so hard to quit. There is a tactile component (holding the cigarette), and there is a social component (if everyone else is smoking, so do you). But perhaps most important, and most challenging to overcome, is the way nicotine affects the brain and the way it makes you feel when you smoke.
Nicotine causes the release of the chemical “dopamine” in the brain’s reward center, which is the area that causes pleasure. Taking away nicotine turns down the dopamine production, and is what causes many of those feelings of withdrawal, and the urge to start smoking again. There are currently two medications available that work in the brain to increase dopamine, and to help you quit smoking.
Bupropion, or Wellbutrin, is a medication that is a type of antidepressant. It works by increasing the amount of dopamine in the brain, to replace what is lost when you stop using nicotine. This in turn reduces withdrawal symptoms and cravings when you have stopped using nicotine, and helps you have a smoother, and more successful, quitting journey. For patients who have some anxiety, depression, or are concerned about weight gain associated with quitting smoking, Bupropion may be a good option for you; it is unsafe for people who have seizures, but is otherwise well-tolerated.
The other medication is called Varenicline, or Chantix. It works by directly attaching where nicotine normally attaches in the brain. It partially stimulates those nicotine receptors and releases dopamine – this mimics the effects of nicotine. Because your brain is getting the dopamine it wants from the Varenicline, you feel less inclined to need a cigarette, and have a reduction in both cravings and withdrawal symptoms. Also, because Varenicline is attached to the nicotine receptors, it blocks the nicotine from attaching to your brain and reduces the enjoyable effects of smoking. Varenicline is generally well-tolerated; insomnia and mild nausea are the most common side effects, but they are short-lived and normally resolve once the body gets used to the medication.
Studies show that the most effective way to quit smoking is a combination of medication and social support, rather than either one alone.
And no, you don’t have to completely stop using cigarettes before you start a medication to help you quit. Gradually weaning down the number of cigarettes per day, while letting the medication decrease your desire to smoke, is an effective way to quit! Again, talk to your healthcare provider about which medication would be best for you!