Quitting smoking is very difficult, as anyone who has tried it knows. When people stop smoking, they often experience unpleasant cravings for nicotine that make it hard to stop. Nicotine is an addictive drug and the body comes to depend on the sensations it produces.

When smokers quit, the withdrawal from nicotine can produce a variety of physical and emotional symptoms including, irritability, difficulty concentrating, anxiety, depression, headache, nausea, constipation or diarrhea, fatigue, drowsiness, insomnia, increased hunger and food intake, cravings for sweets and, of course, tobacco. The first two weeks are the worst, but symptoms may continue for eight to 12 weeks. Withdrawal from nicotine is unpleasant, but the sensations are rarely risky to one's health.

A Range of Resources for Quitters

The decision to quit smoking can greatly improve your health — immediately and for the future. There are ways to make it easier to cope during the process.

One group used nicotine patches alone; one group used a combination of nicotine patches plus nicotine lozenges; and one group used Chantix® (varenicline) alone.

Social support whether online, by telephone, text or in person can be key. There are also a number of medications and over-the-counter products that can ease the symptoms of nicotine withdrawal.

When you are preparing to quit, it's useful to know what help is available. But figuring out which product or products will work best for you can be a challenge. A recent study compared three different protocols for quitting smoking to determine whether any were superior to the others.

Nicotine Replacement Products
Nicotine gum, patches, lozenges, nasal sprays, and inhalers are often available over-the-counter; some require a prescription. Nicotine replacement products act by providing your body with a small amount of nicotine to help you wean yourself off the chemical. They have the advantage of delivering the nicotine without the other dangerous chemicals, such as tar, found in cigarettes.

Nicotine replacement products are meant to be used short-term, to help with the early challenge of smoking cessation. It is wisest to consult with a health care professional when using nicotine replacement products, particularly if one has other health problems such as diabetes, heart disease, asthma, or stomach ulcers.

If you have had a recent heart attack or have high blood pressure that is not controlled with medicine, a history of irregular heartbeat, or if you've been prescribed medication to help you quit smoking, it is important to make sure your doctors agree that nicotine replacement products are right for you.

A non-nicotine containing drug, available only by prescription, is Chantix® (varenicline). Chantix acts on the parts of the brain that are most affected by nicotine, reducing cravings for nicotine and decreasing the pleasurable sensations nicotine brings.

The most common side effects of Chantix® include nausea, constipation, gas, vomiting, trouble sleeping, and unusual or vivid dreams. However, it can also cause changes in behavior, such as depressed mood, hostility, aggression, and suicidal thoughts or attempts. It may also cause new or worsening heart disease, seizures, high blood pressure, and allergies.

What Works Best

Researchers from the Wisconsin School of Medicine and Public randomly assigned about one thousand smokers with the desire to quit into one of three groups. One group used nicotine patches alone; one group used a combination of nicotine patches plus nicotine lozenges; and one group used Chantix® (varenicline) alone.

Withdrawal from nicotine is unpleasant, but the sensations are rarely risky to one's health.

Success was measured by whether the smokers had managed to keep from smoking at 26 and 52 weeks. Participants were asked if they had remained smoke free at both the six-month and one-year marks, and their answers were confirmed by measuring the carbon monoxide levels in their blood.

All three treatments yielded similar results at both six and 12 months. Between 22 to 26% of the participants remained off cigarettes at six months. And between 19 to 20% were smoke-free at one year. No one method was significantly better or significantly worse than the others. All three protocols were tolerated well by the participants but the varenicline group reported more side effects such as vivid dreams, insomnia, nausea, constipation.

The authors concluded that nicotine patches alone, nicotine patches plus lozenges, and varenicline alone were all equally effective in aiding smokers who wanted to quit. The finding suggests that current smokers who are interested in quitting can try one method and then move to another if their initial effort to give up smoking isn't completely successful.

The study is published in JAMA, the Journal of the American Medical Association.