Nicotine Dependence

Diagnosis

To diagnose nicotine dependence, your healthcare professional may ask questions or have you complete a questionnaire. These assessments help determine how dependent you are on nicotine. Factors such as the number of cigarettes smoked daily and the time to the first cigarette after waking indicate the level of dependence.

Treatment

Stopping smoking is often challenging, and most people require multiple attempts. Using a combination of medicines and counseling increases the chances of successfully quitting.

• Medications:

  • Nicotine replacement therapy (NRT) provides controlled amounts of nicotine. Long-acting options include nicotine patches, while short-acting options include gums, lozenges, and nasal sprays. Some NRT products require a prescription, while others do not.

  • Prescription medications without nicotine include bupropion and varenicline. These medicines help reduce cravings and withdrawal symptoms.

  • Using multiple products may improve success rates, but consult your healthcare professional to choose the right combination and schedule and to understand potential side effects.

• Counseling:

  • Counseling teaches skills and techniques to cope with cravings and prevent relapse. Individual or group sessions are offered by hospitals, healthcare plans, and other providers.

  • More frequent and longer counseling sessions usually improve outcomes.

• Alternative methods:

  • Some healthcare professionals may suggest electronic cigarettes if conventional treatments fail. E-cigarettes deliver nicotine through vapor but are controversial due to uncertain long-term health effects. They should only be used under professional guidance.

  • Substituting other forms of tobacco is not recommended. Unsafe alternatives include dissolvable tobacco, smokeless tobacco, nicotine lollipops or balms, cigars, pipes, hookahs, and nicotine pouches.

The combination of medication, counseling, and support is the most effective strategy for quitting smoking and achieving long-term nicotine abstinence.