Last reviewed
Medications to quit smoking: varenicline, bupropion and nicotine replacement
The FDA-approved medications for quitting cigarettes and other tobacco, how they work, and why combining them with support works best.
Earl Johns, MSN, PMHNP-BC
Board-certified psychiatric nurse practitioner and founder of Wellthy Psychiatry & Wellness
✓ Medically reviewed by Earl Johns, MSN, PMHNP-BC
Photos are illustrative and don’t show actual patients.
Quit medications are safe for most people and can double or even triple the chance of quitting for good. Most insurance plans cover them.
Varenicline
Varenicline (formerly sold as Chantix) is generally the most effective single medication. It eases cravings and makes smoking less satisfying. A large study found it safe for most people with mental health conditions, and the FDA removed its boxed warning in 2016. Vivid dreams and nausea are common side effects.
Bupropion
Bupropion SR reduces cravings and withdrawal, and it’s also an antidepressant. It isn’t right for people with a seizure disorder or an eating disorder.
Nicotine replacement
Patches, gum, lozenges, inhalers and nasal spray give steady nicotine without the smoke. Combining a daily patch with a short-acting form for cravings works better than either alone.
Combining treatments
Medication plus counseling or coaching works best. Free coaching is available from 1-800-QUIT-NOW (1-800-784-8669) and Kick It California.
A note for people on psychiatric medications
Quitting smoking can raise blood levels of some medications, such as clozapine and olanzapine. Let your prescriber know your quit date so they can adjust doses if needed.
A gentle next step
Wellthy Psychiatry offers judgment-free, LGBTQ+ affirming care by telehealth across California. A free 15-minute phone consult is an easy way to see if we’re a good fit.
This article is for general education and isn’t medical advice. If you’re in crisis, call or text 988, the Suicide & Crisis Lifeline, or call 911.
About the author
Earl Johns, MSN, PMHNP-BC
Board-certified psychiatric nurse practitioner · UCSF-trained · Founder of Wellthy Psychiatry & Wellness
Earl provides LGBTQ+ and neurodivergent-affirming psychiatric care, blending medication management, therapy and whole-person approaches. His background includes inpatient psychiatry and community mental health at Glenn County Behavioral Health and Equity Health, a federally qualified health center. He sees clients in San Francisco and by telehealth across California.
Keep reading
Related posts
Sexual side effects of SSRIs: what’s common and what helps
Why SSRIs can affect desire, arousal and orgasm, how common it is, and practical options if it’s happening to you.
Antidepressants with fewer sexual side effects
A plain-language look at medications that tend to be easier on desire and orgasm, and the tradeoffs of each.
FDA approvals for common psychiatric medications: a quick guide
What common psychiatric medications are FDA-approved to treat, and why your prescription might not match the label.
Off-label prescribing in psychiatry: what it means and why it’s common
What “off-label” means, why psychiatric prescribers use it, common examples, and good questions to ask.