Medical Treatments & Support
Available treatment options
We have an excellent arsenal of treatments available today. The most common is Nicotine Replacement Therapy (NRT) , which comes in patches, gums, lozenges, and inhalators. Many patients fail with NRT because they under-dose.
My clinical recommendation is almost always 'combination therapy'—using a long-acting patch to manage your baseline withdrawal, alongside a fast-acting gum or spray for breakthrough cravings. We also have prescription-only oral medications like Varenicline (often known as Champix) and Cytisine .
These are fascinating drugs because they bind to the nicotine receptors in your brain, simultaneously reducing withdrawal symptoms and blocking the rewarding effects of smoking if you do relapse.
I often recommend these for heavy smokers who have struggled with NRT in the past.
What to expect from treatment
Setting realistic expectations is vital for success. The acute physical withdrawal phase is the hardest, typically peaking around days three to five. If you are using patches, a very common side effect my patients report is incredibly vivid, sometimes disturbing dreams.
My practical tip: if this disrupts your sleep, simply take the patch off two hours before bed. You might wake up with a stronger craving, but a good night's sleep is often more crucial for your mental resilience during the first week of quitting.
Self-care and prevention
Medication addresses the physical dependence, but we must also tackle the behavioural associations. Your brain has linked smoking to driving, drinking coffee, or finishing a meal. When a craving hits, I teach my patients the '4 Ds': Delay, Deep breathe, Drink water, and Do something else.
A clinical reality that surprises many is that a severe psychological craving typically only lasts three to five minutes. It feels like an eternity, but it is actually a short wave.
If you can distract yourself just long enough to ride that wave, it will crash and recede.
