Treating Tobacco Use and Dependence: PHS Clinical Practice Guideline

Suggestions for the Clinical Use of Pharmacotherapies for Smoking Cessation1


First-line Pharmacotherapies
(Approved for use for smoking cessation by the FDA)

Pharma-
cotherapy
Precautions/
Contraindications
Side
Effects
Dosage Duration Availability Cost/day2
Bupropion SR History of seizure
History of eating disorders
Insomnia
Dry mouth
150 mg every morning for 3 days then 150 mg twice daily
(Begin treatment 1-2 weeks pre-quit)

7-12 weeks maintenance

up to 6 months

Zyban (prescription only) $3.50
Nicotine Gum   Mouth soreness
Dyspepsia

1-24 cigs/day-2 mg gum (up to 24 pcs/day)

25+cigs/day-4 mg gum (up to 24 pcs/day)

Up to 12 weeks Nicorette,
Nicorette Mint,
Nicorette Orange
(OTC only)
Brand name:
$4.54 for 10 2 mg pieces
$5.00 for 10 4 mg pieces
Store brand:
$3.00 for 10 2 mg pieces
$3.70 for 10 4 mg pieces
Nicotine Inhaler   Local irritation of mouth and throat 6-16 cartridges/day Up to 6 months Nicotrol Inhaler
(prescription only)
$10.95 for 10 cartridges
Nicotine Nasal Spray   Nasal irritation 8-40 doses/day 3-6 months Nicotrol NS
(prescription only)
$5.64 for 12 doses
Nicotine Patch  

Local skin reaction

Insomnia

21 mg/24 hours
14 mg/24 hours
7mg/24 hours

15 mg/16 hours

4 weeks
then 2 weeks
then 2 weeks

8 weeks

Nicoderm CQ,
(OTC only),
Generic patches
(prescription and OTC)

Nicotrol (OTC only)

Brand name $3.50
Store brand $2.11

1 The information contained within this table is not comprehensive. Please see package insert for additional information.
2 Prices based on retail prices of medication purchased at a national chain pharmacy located in Madison, Wisconsin, April 2001.
Generic brands of the patch recently became available and may be less expensive.


Internet Citation:

Suggestions for the Clinical Use of Pharmacotherapies for Smoking Cessation. U.S. Public Health Service. http://www.surgeongeneral.gov/tobacco/clinicaluse.htm


Return to Clinician's Packet
Tobacco Cessation Guideline Index
Department of Health and Human Services