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Chronic Obstructive Pulmonary Disease (COPD) (cont.)

Smoking Cessation Using Nicotine Replacement Therapies

The supervised use of medications is an important adjunct to smoking cessation programs.

Nicotine is the ingredient in cigarettes primarily responsible for the addiction. Withdrawal from nicotine may cause a person to have unpleasant side effects, such as anxiety, irritability, difficulty concentrating, anger, fatigue, drowsiness, depression, and sleep disruption. These effects usually occur during the first several weeks after a person stops smoking.

Nicotine replacement therapies reduce these withdrawal symptoms. If you require your first cigarette within 30 minutes of waking up, you are most likely highly addicted and would benefit from nicotine replacement therapy.

Several nicotine replacement therapies are available.

Nicotine polacrilex is a chewing gum. Chewing pieces come in two strengths (i.e., 2 mg, 4 mg). If a person smokes one pack per day, they should use 4-mg pieces. If a person smokes less than one pack per day, they should use 2 mg pieces. Individuals should chew hourly and also chew when needed for any initial cravings within the first 2 weeks. Patients should gradually reduce the amount chewed over the next 3 months.

Transdermal nicotine patches are also available, and are well tolerated. The most common side effect is slight skin irritation where the patch is placed. Examples of brand name nicotine replacement therapy patches are Nicoderm, Nicoderm C-Q, Nicoderm C-Q Clear, Nicotine System Kit, and Habitrol. Each product has a scheduled decrease in nicotine over 6 to 10 weeks.

The use of the antidepressant bupropion (Zyban) is effective. It is a non-nicotine aid to smoking cessation. Bupropion may also be effective for those people who have not been able to quit smoking with nicotine replacement therapies.

A newer class of drugs, involves simulating the nicotine receptors but less so than nicotine, for example, varenicline (Chantix). Studies have indicated that this drug may be more effective than bupropion. As with all drugs, this drug may have many adverse side effects. However, cigarette smoking still remains much worse than side effects, especially if COPD is present

Medically Reviewed by a Doctor on 12/29/2015

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