FDA-approved smoking cessation medications (drugs on the market in Korea;16) 1st line Medications for Tobacco Cessation Treatmenta)
| Drug | Dosing Instruction Administration | Common side effects |
|---|---|---|
| Nicotine patch | Starting dose 21 mg: ≥10 cigarettes/d 14 mg: <10 cigarettes/d After 6 weeks, option to taper to lower doses for 2–6 weeks. Use ≥3 months. After 6 weeks, continue original dose or taper to lower doses (either option acceptable) |
Skin irritation Trouble sleeping Vivid dreams |
| Nicotine lozenge |
4 mg: time to 1st cigarette ≤30 minutes 2 mg: time to 1st cigarette >30 minutes Use ≥3 months Place between gum and cheek, let it melt slowly. Use 1 piece every 1–2 hours (Max: 20/d). May be added to patch to cover situational cravings. |
Mouth irritation Hiccups Heartburn Nausea |
| Nicotine gum |
4 mg: time to 1st cigarette ≤30 minutes 2 mg: time to 1st cigarette >30 minutes Use ≥3 months Chew briefly until mouth tingles, then ‘park’ gum inside cheek until tingle fades. Repeat chew-and park each time tingle fades. Discard gum after 30 minutes of use. Use ~1 piece per hour (Max: 24/d) |
Mouth irritation Jaw soreness Heartburn Hiccups Nausea |
| Varenicline |
Days 1–3: 0.5 mg/d Days 4–7: 0.5 mg twice a day Day 8+: 1 mg twice a day Use 3–6 months Start 1–4 weeks before quit date Take with food and a tall glass of water to minimize nausea Quit date can be flexible, from 1 week to 3 months after starting drug |
Nausea Insomnia Vivid dreams Headache |
| Bupropion sustained release (SR) |
150 mg/day for 3 days, then 150 mg twice a day Use 3–6 months Start 1–2 weeks before quit date May lessen post-cessation weight gain while drug is being taken. Because of previous FDA boxed warning (now removed), many patients fear psychiatric adverse events, even though they are no more common than with other cessation medications. |
Insomnia Agitation Dry mouth Headache |
aAll are FDA-approved as smoking cessation aids and listed as a 1st line medication by U.S. Clinical Practice Guidelines (Fiore et al., 2008).20)
Revised from the article of Barua et al. (J Am Coll Cardiol 2018; 72: 3332-65).16)