Overview
Roughly 70% of adult smokers say they want to quit — but only ~7% who try on willpower alone succeed for a year. Medication changes those odds dramatically. The three FDA-approved first-line options are varenicline (Chantix), bupropion (Zyban), and nicotine replacement therapy (NRT). Combining a long-acting nicotine patch with a short-acting form (gum, lozenge, inhaler) roughly doubles quit rates versus a single product. Add a set quit date, a trigger plan, and 12 weeks of follow-up and you're operating with the same tools clinical trials use.
Symptoms to watch for
- Cravings that come in ~3-minute waves
- Irritability, anxiety, and low mood in the first week
- Trouble concentrating
- Increased appetite and weight gain (average 5–10 lb)
- Insomnia and vivid dreams
- Cough that temporarily worsens as cilia recover
What else could this be?
- Nicotine dependence — the biological driver, treated the same for cigarettes, vapes, and pouches
- Anxiety or depression flaring as nicotine masks symptoms — screen and treat concurrently
- Cannabis co-use — separate quit plan; nicotine medications don't cover it
- Chronic cough or COPD — treat the underlying lung disease alongside quitting
How it's diagnosed
Quitting doesn't require a diagnostic workup, but Clindle screens for cardiovascular disease, uncontrolled depression, seizure history, and pregnancy before choosing a medication. We check baseline blood pressure and, when relevant, order spirometry or a chest X-ray if COPD is suspected.
Treatment
Varenicline (Chantix) — start 1 week before your quit date, titrate to 1 mg twice daily for 12 weeks; the most effective single agent. Bupropion (Zyban) — 150 mg daily for 3 days then 150 mg twice daily, also start 1 week before quit date; useful if you also have depression or want to avoid weight gain. Combination NRT — 21 mg patch daily plus 2 mg or 4 mg gum/lozenge as needed for breakthrough cravings, taper over 8–12 weeks. Behavioral support — text2quit, 1-800-QUIT-NOW coaching, and identifying trigger routines. Vaping is treated the same way.
When to book a visit
Book a Clindle visit when you've decided you want to quit — we can prescribe varenicline, bupropion, or NRT the same day and set a quit date 1–2 weeks out.
Book online todayFrequently asked
Is Chantix safe? I heard about mood-side-effect warnings.
The FDA removed the black-box warning for neuropsychiatric side effects in 2016 after large trials (EAGLES) showed varenicline does not increase serious psychiatric events versus placebo. We still monitor mood, especially in patients with a history of depression.
How is vaping cessation different from cigarette cessation?
The medications are the same. Vape users often need higher-dose NRT because pod devices deliver more nicotine than cigarettes. We adjust the patch and gum strength accordingly.
Will I gain weight?
Most quitters gain 5–10 lb in the first year. Bupropion and combination NRT blunt this. Weight gain is far less harmful than continued smoking.
Can Clindle prescribe Chantix or Zyban same-day?
Yes — after a brief video visit to confirm you're a candidate. Neither is a controlled substance, and both can be sent to your pharmacy the same day.
Does insurance cover cessation medication?
Under the ACA, most plans cover FDA-approved cessation medications and counseling with no cost-sharing. We help verify benefits during your visit.