Cigarette smoking is the most common preventable cause of premature death in Canada. 

Until the discovery of Bupropion, nicotine replacement therapy (NRT) was the only available form for smoking cessation. Bupropion is the first non-nicotine-based medicine for quitting smoking. Various studies have proven the efficacy of Bupropion for smoking cessation, helping almost one in five individuals stop smoking. The use of Bupropion may cause some minor side effects such as a dry mouth and insomnia, but it rarely causes seizures.

Let’s learn more about smoking cessation and how Bupropion helps.

What Causes Smoking Cessations?

Smoking causes the release of chemicals that provide pleasure. The release of these chemicals has an addictive behavior. Once you stop smoking, the levels of these chemicals decrease in your brain, resulting in nicotine withdrawal symptoms.

These symptoms can start within 30 minutes of your last smoke, and their severity depends on the level of addiction.

Some common symptoms include:

  • Tingling of hands and feet
  • Intense craving for nicotine
  • Nausea
  • Sweating
  • Abdominal cramps
  • Bloating and constipation
  • Coughing
  • Headaches
  • Sore throat
  • Difficult in concentrating
  • Insomnia
  • Depression
  • Weight gain
  • Anxiety
  • Irritability

The symptoms usually peak by two or three days. The nicotine receptors are adapted to nicotine use, and stopping it will cause you to crave it.

But as you ignore the craving, it begins to disappear. 

These withdrawal symptoms may last for 4-8 weeks or even longer. Some people may find it challenging to cope with these symptoms and usually succumb. 

But the good news is that many treatment options are available to help you manage the withdrawal symptoms, supporting you to quit smoking.

Thanks to these treatments, there are more ex-smokers than current smokers.

Common Treatments

Different treatment therapies, from counseling to medications, are available to help smokers quit. If you are a smoker and trying to stop, your healthcare worker may prescribe single or multiple treatment options.

Before we move ahead, it is essential to understand that nicotine is not the constituent of tobacco smoke that causes cancer. So, it is safe to use nicotine replacement.

Besides, don’t lose hope if you cannot quit on the first attempt. The majority of smokers need about 8-10 attempts before they stop smoking.

Self-Help

Self-help interventions such as pamphlets, audiotapes, videotapes, helplines, and community programs are available. But they are not very effective. 

Counseling 

Two main types of therapies are effective to help to quit:

  • Practical counseling
  • Support and encouraging

Bupropion 

Bupropion or Wellbutrin is the first non-nicotine medicine used for smoking cessation. (More on this in the next section).

Nicotine Replacement Therapy 

Nicotine replacement therapy (NRT) partially replaces nicotine obtained from cigarettes to reduce the severity of withdrawal symptoms. NRT is available in different forms, such as patches and gum.

NRT can also be used along with medications. However, NRT is not recommended for pregnant women who are trying to quit.

NRT is available in the following forms:

  • Nicotine gum: When chewed, it releases nicotine in the blood, which reaches the brain within minutes. It is seen that more than 14-weeks of use of nicotine gum increases your chance of quitting. The recommended dose is 2mg, but for heavy smokers, it is 4mg.
  • Nicotine inhaler: They are thin plastic tubes containing nicotine cartridges. When you use the inhaler, it releases nicotine vapor. It is the closest thing resembling cigarette smoking. 
  • Nicotine lozenge: This tablet dissolves in the mouth to release nicotine.
  • Nicotine nasal spray: The spray delivers nicotine through the nose that quickly enters the bloodstream.
  • Nicotine patch: The patch release nicotine through the skin. 

Varenicline (Chantix) 

Varenicline helps with withdrawal symptoms and craving for nicotine. It works by reducing the physical effects of nicotine. This means that if you start smoking, after quitting, you will not get much pleasure.

However, it should be combined with NRT.

How Does Bupropion Help?

When you smoke a cigarette, nicotine released is absorbed in the blood that crosses the blood-brain barrier. This results in the releases of dopamine in the pleasure-seeking pathway of the brain.

When you lower your nicotine intake, the nerve cells reuptake dopamine. The decrease in dopamine levels results in nicotine withdrawal symptoms. Bupropion works by inhibiting this reuptake of dopamine, increasing its level in the brain. By improving the level of dopamine, Bupropion prevents or attenuates nicotine withdrawal symptoms.

Noradrenalin release is also seen in many substance withdrawals. Bupropion is a weak noradrenaline reuptake inhibitor, reducing withdrawal symptoms. 

Experts believe that Bupropion antagonizes the effect of nicotine, blocking its effect. It is also seen to prevent nicotine-induced dopamine release, combating the reinforcing effect present in long-term nicotine addiction.

All in all, Bupropion works by influencing the brain chemicals related to nicotine craving. It can be used alone or in combination with NRT for smoking cessation. 

Use and Dosage

How to take it:

  • Your physician will advise you to take Bupropion a week before you plan to stop smoking.
  • You may have to take this medicine for 7 – 12 weeks.
  • The usual dose is a 150 mg tablet once or twice a day. There should be a gap of at least 8 hours between two doses.
  • You have to swallow the medicine as a whole.
  • DO NOT split, crush, or chew it. Doing so may increase the risk of side effects, including seizures.

Initially, if you crave nicotine, you can take Bupropion with NRT. However, always consult a doctor before doing so.

Other Precautions and Care

Side Effects

The use of Bupropion is usually safe in most individuals; however, it may cause some side effects.

Here are some common side effects:

  • Dryness of mouth
  • Insomnia
  • Nausea
  • Diarrhea
  • Constipation
  • Fatigue
  • Behavioral changes such as agitation, anger, suicidal thoughts, or depressed mood

Seek immediate medical care if you have the mentioned side effects:

  • Irregular heartbeat
  • Chest pain
  • Muscle aches
  • Ringing in the ears
  • Severe headache
  • Tremors
  • Change in weight

Precautions

Avoid the use of Bupropion in the following cases:

  • Head injury
  • Eating disorders
  • Pregnancy
  • Arteriovenous malformation
  • Mood disorders
  • Glaucoma
  • Diabetes
  • Heart diseases
  • Kidney disorders
  • Hypertension

Other Things That May Help

Nicotine withdrawal is usually the most challenging part of smoking cessation. Many people may have to try multiple times before they can successfully quit.

Some triggers may trigger you to smoke. Some common triggers are:

  • Being around smokers
  • Feeling stressed
  • Drinking alcohol
  • Feeling bored
  • Talking on the phone
  • Being in a car
  • Drinking tea or coffee

Try and identify your triggers and try to avoid them.

The first week may be daunting, and you may get a nicotine craving. Sustaining that phase is important because soon, your body will get used to it.

Some activities that may help are:

  • Take a walk
  • Listen to music
  • Participate in a hobby
  • Talk to your loved ones

Final Thoughts

If you are a smoker and planning to quit, many therapies are available to support you. When you smoke, nicotine causes the release of brain chemicals associated with pleasure. Your cells get used to nicotine and sensations caused by it.

Once you stop, the levels of pleasure chemicals reduce, resulting in nicotine withdrawal symptoms. Your body needs time to get used to the absence of nicotine. Fortunately, many treatment options can help you cope with these symptoms. Bupropion is the first non-nicotine-based medicine that helps in smoking cessation. It works by increasing the levels of pleasure chemicals, attenuating withdrawal symptoms.

If you feel Bupropion may help you, talk to your doctor about it today!

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