# Smoking Cessation

- Category: chronic
- Review status: reviewed (every claim checked against a document named on this page)
- Sources: WHO Guidelines for the Treatment of Tobacco Dependence 2021 · Zyban 150 mg prolonged release tablets SmPC sections 4.2-4.4 (eMC product 3827) · Nicorette 2 mg Gum SmPC sections 4.2 and 4.4 (eMC product 1089)
- Verified date: 2026-08

## Verified against

- Nicorette 2 mg Gum SmPC sections 4.2 and 4.4 (eMC product 1089)
- Zyban 150 mg prolonged release tablets SmPC sections 4.2-4.4 (eMC product 3827)

## Treatment metadata

- Nicotine — 2 mg — oral.solid
- Bupropion — 150 mg — oral.solid

## Complete treatment card

```text
SMOKING CESSATION
Sources: WHO Guidelines for the Treatment of Tobacco Dependence 2021 · Zyban 150 mg prolonged
         release tablets SmPC sections 4.2-4.4 (eMC product 3827) · Nicorette 2 mg Gum SmPC sections
         4.2 and 4.4 (eMC product 1089)
Review status: REVIEWED against 2 sources listed above  (2026-08)

1. NICOTINE                                               [1st line]
   Adult    Chew 2 mg gum when urge occurs (up to 15 pieces daily; 4 mg if >20 cigarettes/day) x
            8-12 weeks
   Peds     12 years and over: 2 mg gum, under medical supervision
            (Adolescents >=12 years: 2 mg gum under medical supervision)
   Source   Nicorette 2 mg Gum SmPC sections 4.2 and 4.4 (eMC product 1089)
   Why      Nicotine gum is a form of nicotine replacement therapy that supplies nicotine without
            the tar and combustion products of cigarettes, easing withdrawal symptoms and cravings
            during a quit attempt.
   Caution  Caution in recent myocardial infarction, unstable angina, or severe arrhythmia.
            Use 'chew and park' technique (chew slowly until tingling, then park between cheek and
            gum).
            Avoid acidic beverages (coffee, juice) 15 minutes before and during use.
            Chew and rest, not chew continuously: chew until the taste is strong, then park the gum
            against the cheek until it fades, and repeat for about half an hour. Chewing it like
            ordinary gum swallows the nicotine and gives hiccups and heartburn instead of a blood
            level.
            Fifteen pieces a day is the ceiling. Coming off the 4 mg, stepping down to the 2 mg
            helps.
            It sticks to dentures and can damage them.
   Egypt    NICORETTE FREHMINT GUM 2 MG 30 PIECES MCNEIL PRODUCTS LTD. > JOHNSON & J...   161.00 EGP
                -> ? different route - not oral solid

2. BUPROPION                                              [2nd line]
   Adult    150 mg once daily for 6 days, then 150 mg twice daily (8 hours apart) x 7-9 weeks
            (target stop date set in week 2)
   Peds     Not recommended under 18 years
   Source   Zyban 150 mg prolonged release tablets SmPC sections 4.2-4.4 (eMC product 3827)
   Why      Atypical antidepressant that reduces nicotine craving and withdrawal by modulating
            dopamine and noradrenaline reuptake in the brain; a non-nicotine pharmacotherapy option
            for smoking cessation.
   Caution  CONTRAINDICATED in patients with epilepsy, eating disorders, or CNS tumour.
            Monitor blood pressure and mental health changes.
            Set the quit date inside the first two weeks, ideally the second - the drug is started
            before the cigarettes stop, not after.
            Seven to nine weeks in total. If nothing has changed by seven weeks, stop rather than
            continue.
            Roughly one person in a thousand has a seizure at the full 300 mg. That is why the
            contraindications are absolute: any history of seizures at all, bulimia or anorexia now
            or ever, bipolar disorder, an MAOI within fourteen days, or a patient coming off alcohol
            or benzodiazepines abruptly.
            Never more than 150 mg in one dose or 300 mg in a day, and at least 8 hours between
            them.
            There is a risk of insomnia; avoid second dose near bedtime.
   Egypt    BUPROFUTAL SR 150 MG 30 TABS     FUTURE PHARMA...   152.00 EGP (5.07/unit)
            VIXADEP 150 MG 30 S.R.TABS.      MARCYRL PHARM...   221.00 EGP
            WELLINTA 150 MG 30S.R.F.C.TABS.  HOCHSTER PHAR...   291.00 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.
```

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Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement.

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