Korean Journal of Family Practice

Table. 1.

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)

Korean J Fam Pract 2021;11:403~414 https://doi.org/10.21215/kjfp.2021.11.6.403
© KJFP