By Pat Bass, MD

“Doc, do I need medication to help me quit smoking?”

Maybe. I generally recommend a combination of behavioral and pharmacologic treatments, as this tends to produce the best results.

If you think you are addicted to cigarettes or you’re displaying signs of nicotine withdrawal, nicotine replacement therapy can improve your chances of quitting for good. Nicotine replacement decreases cravings and withdrawal symptoms.

Nicotine is highly addictive because of its fast uptake into the blood stream, passage into the brain and the resulting pleasurable response. That’s one reason many people find it so difficult to quit.

Don’t be discouraged if you don’t quit on your first try. Tobacco cessation is not easy, but many people succeed each day. Some require multiple attempts to become tobacco free.

The U.S. Centers for Disease Control and Prevention (CDC) offers tips and resources to help increase your chance of being smoke-free for good.

  • More than 1,300 Americans die of smoking every year, according to CDC.
  • A startling 21 percent of people with asthma smoke cigarettes even though it’s a well-known asthma trigger.

Signs Of Nicotine Addiction

Do you wonder if you’re addicted to nicotine? See if you identify with any of the following scenarios:

  • I smoke first thing in the morning.
  • It’s difficult to go to places where I cannot light up.
  • When I am out of cigarettes it is unbearable until I can smoke.
  • I crave a cigarette when I am somewhere I cannot smoke or I’ve gone an extended period without smoking.

Nicotine, like many drugs, leads to both dependence, the negative response your body feels when it does not receive nicotine, and tolerance, increasing amounts of nicotine required to achieve the same pleasurable effect.

Signs of Nicotine Withdrawal

  • Anxiety
  • Cravings
  • Depression
  • Difficulty concentrating
  • Increased appetite
  • Mood swings and irritability
  • Poor sleep
  • Restlessness or fidgetiness
  • Weight gain

Many patients also describe a significant emotional loss, similar to ending a relationship, when trying to quit smoking.

Symptoms tend to peak during the first several days of quitting and gradually decrease over a few weeks.

Nicotine Replacement Therapy Options

Nicotine replacement therapy may help when cravings are strongest – talk with your physician about it.

Nicotine gum and patches are available over the counter and there are nicotine products available by prescription. Most work fairly well and treatment can be tailored to when you think you would be most likely to relapse.

For patients concerned about finances, most states offer free counseling and nicotine replacement as part of settlement agreements between states and Big Tobacco. A free telephone quit line (1-800-QUIT-NOW) provides support and counseling is available nationally.

Pat Bass, MD, is Associate Professor of Medicine and Pediatrics at Louisiana State University Health Science Center in Shreveport, Louisiana. In addition to a clinical practice, administrative duties and participation in medical education activities, Dr. Bass participates in research focusing on how patients can better interact with and get more out of the healthcare system. Dr. Bass is the author of research articles addressing patient education and is the asthma expert for (

Dr. Bass also runs the website Parents Guide to Asthma where you can download his free report “Who Are You Quitting For: Tips, Tricks and What You Need to Know and Do.”