Therapy	Availability	Dosage	Prescribing instructions	Precautions	Side effects	Studied in adolescents?	Cost (generic)*
Bupropion (Zyban)	Rx	150 mg daily for 3 days, then twice daily for 7 to 12 weeks	Stop smoking one week after starting treatment Avoid or minimize alcohol intake Do not cut, crush, or chew tablets Separate doses by at least 8 hours to avoid insomnia; take last dose before 6 p.m.	FDA pregnancy category B Use caution in patients with seizure disorders, eating disorders, alcoholism, or uncontrolled hypertension, and in those who have taken a monoamine oxidase inhibitor within the past 14 days	Seizures, arrhythmias, Stevens- Johnson syndrome, erythema multiforme, hallucinations, mania, suicidality, hypertension, migraines	Yes; safe and mildly effective as monotherapy. Not as effective when used in combination with nicotine replacement therapy12–14	$174 ($116) per month
Nicotine gum (Nicorette)	OTC	1 piece every 1 to 2 hours for 6 weeks, then every 2 to 4 hours for 3 weeks, then every 4 to 8 hours for 3 weeks 2-mg gum should be used by patients who smoke ≤ 25 cigarettes per day (maximum, 30 pieces per day) 4-mg gum should be used by patients who smoke > 25 cigarettes per day (maximum, 20 pieces per day)	Chew to activate taste, then hold between mouth and gum for 30 minutes or until taste disappears	FDA pregnancy category D Use caution in patients with cardiovascular disease, arrhythmias, or worsening angina, and in those with a history of myocardial infarction within the past two weeks	Mouth soreness, hiccups, heartburn, jaw pain, tooth disorders, headache, nausea	Yes; effective when combined with counseling15	$47 for 110 pieces ($42 to 47)
Nicotine inhaler (Nicotrol Inhaler)	Rx	6 to 16 cartridges daily (1 cartridge = 4 mg) After initial therapy for 6 to 12 weeks, taper over 6 to 12 weeks	Stop smoking at onset of treatment Avoid acidic beverages Use frequent, continuous puffing for 20 minutes per cartridge	Same as above Use caution in patients with asthma	Bronchospasm, mouth or throat irritation, cough, headache, rhinitis, dyspepsia, taste changes	No	$133 for 168 cartridges es
Nicotine lozenge (Commit)	OTC	1 piece every 1 to 2 hours for 6 weeks, then every 2 to 4 hours for 3 weeks, then every 4 to 8 hours for 3 weeks 2-mg lozenges should be used by patients who smoke their first cigarette > 30 minutes after awakening 4-mg lozenges should be used by patients who smoke their first cigarette ≥ 30 minutes after awakening	Dissolve in mouth over 20 to 30 minutes Do not chew, bite, or swallow Do not eat or drink for 15 minutes before and after use	Same as above	Headache, diarrhea, heartburn, hiccups, flatulence, nausea, sore throat	No	$78 for 192 2-mg lozenges
Nicotine nasal spray (Nicotrol NS)	Rx	1 or 2 sprays in each nostril every hour (maximum, 80 sprays daily for both nostrils) After initial therapy for 8 weeks, taper over 4 to 6 weeks	Stop smoking at onset of treatment Deliver spray with head tilted slightly back Do not sniff, swallow, or inhale spray	Same as above	Bronchospasm, nasal or throat irritation, watery eyes, sneezing, cough, headache, rhinitis	No	$148 for four 10-mL bottles
Nicotine patch (Nicoderm, Nicotrol)	OTC	Nicoderm Patients who smoke 6 to 10 cigarettes per day: 14 mg daily for 6 weeks, then 7 mg daily for 2 weeks Patients who smoke more than 10 cigarettes per day 21 mg daily for 6 weeks, then 14 mg daily for 2: weeks, then 7 mg daily for 2 weeks Nicotrol Patients who smoke 6 to 10 cigarettes per day: 10 mg daily for 6 weeks, then 5 mg daily for 2 weeks Patients who smoke more than 10 cigarettes per day 15 mg daily for 6 weeks, then 10 mg daily for: 2 weeks, then 5 mg daily for 2 weeks	Stop smoking at onset of treatment Place patch on hairless location of upper body or outer arm; rotate sites Nicoderm CQ or generic: remove after 16 to 24 hours Nicotrol: remove every night	Same as above	Skin irritation, headache, nausea, insomnia	Yes; safe and effective as monotherapy or when combined with counseling; not as effective as in adult smokers14,16–18	$63 for 28 14-mg patches ($60)
Varenicline (Chantix)	Rx	0.5 mg daily for 3 days, then 0.5 mg twice daily for 4 days May continue for an additional 12 weeks if treatment is successful	Stop smoking after 7 days of treatment Take with food	FDA pregnancy category Adjust dosage in renal-impaired patients Not approved for use in patients younger than 18 years	Nausea, insomnia, headache, abnormal dreams, constipation, flatulence, headache, vomiting	No	$108 for 56 pills