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Drugs & Psychology

One problem with using only prescription drugs to quit smoking is that drugs focus primarily on the physical addiction to nicotine, and not the psychological dependence, in spite of the psychoactive effects. 


Chantix and Zyban have been shown to help people quit, but you can improve your chances by combining these drugs with effective techniques for eliminating the psychological dependence, too. 


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Overview: Prescription Drugs to Quit Smoking

There are two FDA-approved quit smoking drugs. Bupropion (marketed as Wellbutrin and Zyban), and Varenicline (marketed as Chantix). These medications both require a doctor's prescription.

These medications are different from other quit smoking aids like the patch and nicotine gum because they don't contain any nicotine. Where nicotine replacement products like the patch work by providing a replacement source of nicotine, these FDA-approved quit smoking drugs work in a different way.

There is also a quit smoking vaccine under development which is showing some promise of effectiveness.

Zyban and Chantix

Bupropion, the active ingredient in Zyban, was originally developed as an antidepressant (brand name Wellbutrin) and later approved by the FDA to be used as a quit smoking drug. It appears to improve the chances for successful quitting mainly by reducing withdrawal symptoms, although no one is certain exactly how it does this.

The active ingredient in Chantix is a drug called varenicline, which was actually developed specifically to help people quit smoking. It works on receptors in the brain to do two things: 1) It mimics some of the effects of nicotine in the brain, even though it doesn't contain any nicotine. This is intended to reduce cravings and nicotine withdrawal symptoms. 2) It also blocks the nicotine receptors in the brain, which is intended to make smoking less pleasurable if you do smoke while using this drug. Theoretically, if your brain isn't getting the nicotine 'payoff,' it should be easier to quit.

Success Rates for Zyban and Chantix

Meta analytic research, which computes the outcomes from multiple research studies, showed that both of these drugs had a similar success rate: About twice as many people who got one of these quit smoking drugs were able to quit and stay quit compared to people who got a placebo or 'fake' medicine. In all of these studies, the participants in both the treatment group and in the control group were on a behavioral plan in addition to the drug or placebo.

My Recommendations

If you are considering a prescription medication to help you quit smoking, choose either Bupropion (Zyban) or Varenicline (Chantix). Both have been shown to improve people's chances of quitting by a factor of about two. None of the other medications to quit smoking have shown any evidence of effectiveness except nortriptyline, which seems to have more side effects than it's worth for most people.

I'd also recommend that you find a good quality behavioral program or plan designed to help eliminate the psychological dependence on smoking.  It's easy to think that prescription medicine is a 'magic pill' that will provide all you need to quit, but for most people, this is simply not true. Even the studies designed to show the effectiveness of these quit smoking drugs included a behavioral program in addition to the drug treatment.

If you are considering using quit smoking medications, read more about Zyban (bupropion) and Chantix (varenicline), and make an appointment to check in with your doctor about whether you are a good candidate for one of them. In the meantime, you'll want to begin researching compatible behavioral programs to help eliminate the psychological addiction. You can read a little about the psychological aspects of smoking here

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