Nicotine dependence treatment Elbląg

Treatment starts with a medical appointment, for which no referral is needed. Nasz Gabinet Elbląg at Grobla Świętego Jerzego 14A is open every day from 8:00 to 20:00. The first appointment costs PLN 250, and a patient who chooses an online appointment pays the same. We also treat people from Malbork, Braniewo, Pasłęk and Nowy Dwór Gdański online, so they do not have to travel to Elbląg.

Who provides treatment?

The doctor diagnoses nicotine dependence, also called nicotine addiction, and assesses the patient's health. The doctor also decides whether the patient needs a stop-smoking medicine and, if so, chooses the medicine and dose. The patient meets an addiction therapist in online sessions, each costing PLN 250. In these sessions, they learn to recognise the situations in which they used to reach for a cigarette and plan how to cope with them without smoking. If the patient is being treated with the Nasz Gabinet app, medical staff can see in it whether they are taking the medicine according to the treatment plan. If alcohol is a problem as well as cigarettes, the patient can start addiction therapy in Elbląg at the same time.

How does an online appointment differ from one at the practice?

At the practice, the doctor can measure the patient's blood pressure and pulse. This matters when choosing a medicine, because cytisine can raise blood pressure and speed up the heart rate. Before an online appointment, the patient measures their blood pressure at home and prepares a list of the medicines they take regularly. If they have been treated in hospital for heart or lung disease, they keep the discharge summary to hand.

Cytisine and nicotine medicines can be bought without a prescription, so after an online appointment the patient buys the recommended medicine at a pharmacy near home. If the doctor decides the patient needs to be examined, we book an appointment at the practice.

Nicotine from smoke reaches the brain and, through nicotinic receptors, increases the amount of dopamine released there. In someone who smokes every day, the brain adapts to a steady supply of nicotine. That person needs nicotine to feel normal. Nicotine clears from the blood quickly, so its level falls between cigarettes. A dependent person then feels growing tension, irritability and an urge to smoke, and the next cigarette removes these symptoms.

A review of research on stress in smokers, published in 1999 in a journal of the American Psychological Association, showed that adult smokers feel slightly more stress than non-smokers. In teenagers, stress increased as they started to smoke regularly, and after quitting, stress levels fell. Smokers said they felt normal while smoking and were in a worse mood between cigarettes. The author of the review concluded that cigarettes do not reduce stress, but only briefly remove the tension caused by a lack of nicotine, and that nicotine dependence appears to increase stress.

In the first days without cigarettes, tension may therefore get worse, because it is a symptom of nicotine withdrawal. A stop-smoking medicine eases withdrawal symptoms, and in sessions with an addiction therapist the patient practises ways of dealing with stress that do not involve smoking.

Low mood can also be a symptom of nicotine withdrawal, and quitting smoking can make depression the patient had before worse, even when quitting without medication. Suicidal thoughts occur rarely. A clear worsening of mood is a reason to contact the doctor before the next appointment. Suicidal thoughts need immediate medical help.

Cytisine and nicotine medicines in patches, gum, spray and lozenges can be bought without a prescription. The doctor chooses from them based on the patient's health, age and medicines, as well as how much and when they smoke. The effectiveness of the medicines was compared in a review by Cochrane, an organisation that gathers and assesses the results of clinical trials. The review covered 319 studies involving more than 157,000 adults.

In the Cochrane review, effectiveness was assessed on the basis of not smoking after at least six months. The differences given come from comparing treatment with placebo or no medicine.

When does the doctor recommend cytisine?

Cytisine is found in Desmoxan, Tabex and Recigar. It binds to nicotinic receptors more strongly than nicotine and gradually pushes nicotine out of them, but stimulates them more weakly. In this way it eases withdrawal symptoms, and nicotine from a cigarette smoked during treatment no longer fully stimulates the reward system in the brain. In the Cochrane review, cytisine helped 7 more people in every 100 quit smoking compared with groups given no medicine or placebo.

Treatment lasts 25 days, and the patient stops smoking by day 5 at the latest. A pack of 100 Desmoxan tablets is enough for the whole course. In September 2026, cytisine for a full course cost about PLN 40 to 78 in online pharmacies. A woman who is pregnant or breastfeeding must not take cytisine. It is also not taken by people who have recently had a heart attack or stroke, or who have unstable angina or significant heart rhythm disorders. The manufacturer of Desmoxan also does not recommend it for people under 18 or people with impaired liver or kidney function.

When does the doctor recommend a nicotine patch?

A patch releases nicotine through the skin at a steady rate, so the patient does not have to remember doses during the day. NiQuitin Przezroczysty is changed once a day, while Nicorette Invisipatch is put on in the morning and taken off before bed, after 16 hours. The doctor recommends a patch, among other situations, when the patient cannot take cytisine. A patch alone helped 2 more people in 100 quit smoking.

A course of NiQuitin patches usually starts with 21 mg a day patches, which the patient uses for 6 weeks. For the next 2 weeks, they use the 14 mg patch, and for the last 2 weeks the 7 mg patch. A person who smokes no more than 10 cigarettes a day starts at 14 mg and finishes treatment after 8 weeks. In September 2026, 24-hour patches for the whole 10-week course cost about PLN 606 to 930.

When does the doctor recommend gum, spray or lozenges?

Nicorette Classic Gum, Nicorette Spray and NiQuitin MINI lozenges work faster than a patch. The patient uses them when the urge to smoke comes, so they help get through a sudden craving. The doctor may also combine them with a patch. For fast-acting forms of nicotine, the combined result was about 3 more non-smokers in 100 compared with placebo or no medicine. A patch combined with gum, spray or lozenges did only slightly less well than cytisine in the review, and the difference between them was uncertain.

People usually chew 8 to 12 pieces of gum a day, and no more than 15. The manufacturer recommends 4 mg gum for someone who smokes more than 20 cigarettes a day or did not quit while using 2 mg gum. Treatment with gum lasts at least 3 months, after which the number of pieces is gradually reduced. At 8 to 12 pieces a day, a pack of 105 lasts about 9 to 13 days. In September 2026, such a pack of 4 mg gum could be bought for PLN 78 to 100. A spray with 150 doses cost PLN 62 to 85 at the time.

Can varenicline and bupropion still be bought?

Varenicline, the active substance in Champix, works in a similar way to cytisine and in the same review helped 8 more people in 100 quit smoking. Bupropion, found in Zyban, contains no nicotine and helped 3 more people in 100. Both medicines require a prescription. In September 2026, Champix was not available in the pharmacies we checked, and the marketing authorisation for Zyban expired in December 2023. That is why in Elbląg we treat mainly with cytisine and nicotine medicines.

Yes. In a summary of 17 studies from 7 countries involving people aged 60 and over, smokers had a 1.83 times higher risk of death than people who had never smoked. In former smokers, this risk was 1.34 times higher and fell the longer they had not smoked. The authors of the summary found benefits from quitting in all age groups, including people over 80.

How is a stop-smoking medicine chosen after the age of 65?

The manufacturer of Desmoxan does not recommend cytisine for people over 65, because clinical experience in this group is limited. The manufacturers of NiQuitin patches, Nicorette Classic Gum and Nicorette Spray give the same dosage for older people as for younger adults. In healthy older people, the body clears nicotine a little more slowly, but according to the manufacturer of the spray this does not require a change of dose. For an older patient, the doctor therefore considers a nicotine medicine and, before choosing it, checks whether the patient has recently had a heart attack or stroke.

Older people usually take more medicines regularly, so the patient brings a full list of them to the appointment. Tobacco smoke speeds up the breakdown in the liver of some medicines, such as theophylline, used for lung disease, and ropinirole, used for Parkinson's disease among other conditions. After quitting smoking, their blood levels may rise, so the doctor who prescribed them may change the dose.

Should you quit smoking after a diagnosis of lung cancer?

In an analysis of 10 studies, most of them involving patients with early-stage lung cancer, continued smoking was linked to a higher risk of death and of the cancer coming back. On this basis, the authors estimated what percentage of 65-year-old patients with early-stage non-small cell lung cancer would survive 5 years. Among those who kept smoking, it would be 33 percent, and among those who quit, 70 percent. In limited-stage small cell lung cancer, the figures were 29 and 63 percent.

The authors considered this evidence preliminary, because it came mainly from observational studies. A patient undergoing cancer treatment brings their hospital discharge summary and a list of their medicines to the appointment, so that the doctor can take them into account when choosing a stop-smoking medicine.

The Nasz Gabinet app sends a reminder for every dose of medicine at the time the doctor entered in the treatment plan. Once a day, the app picks one dose at random, and the patient records a video of themselves taking it on their phone; they confirm the other doses with a single tap. If a dose is not confirmed, the app reminds them again.

When a strong urge to smoke comes, the patient records in the app how strong it was, in what situation it appeared and what helped them get through it. The app then suggests a short exercise, for example a breathing exercise. Before an online session, the addiction therapist reviews these entries, so they talk with the patient about the situations that were genuinely hard.

Only the doctor changes the medicine or dose. The app itself is free to download, and the fee is for access to the treatment programme. Anyone who wants to be treated with the app calls Nasz Gabinet Elbląg or comes to Grobla Świętego Jerzego 14A. In person or over the phone, we will help them buy access to the programme and install the app, and then enter the treatment plan into it.

• We do not give injections for quitting smoking. Vaccines have been studied that were meant to make the body produce antibodies that hold nicotine in the blood before it reaches the brain. In a review of 4 studies involving 2,642 smokers, none of these vaccines increased the number of people who did not smoke for at least six months. When the review was published in 2012, no nicotine vaccine had been approved for use in any country.
• We do not offer nicotine detox by drip. The body clears nicotine on its own. According to the manufacturers of nicotine medicines, half of the nicotine leaves the blood within about 2 hours, and half of the cotinine, the main breakdown product of nicotine, within 15 to 20 hours. Withdrawal symptoms and cravings come from the brain's adaptation to nicotine, not from nicotine left in the body, so they are eased by a medicine that acts on nicotinic receptors, not by a drip.

After quitting smoking, the sense of smell may improve. In a US study, 638 people identified 40 smells in a smell test. Smokers had an impaired sense of smell almost twice as often as people who had never smoked, and the more someone smoked, the weaker their sense of smell. In former smokers, the sense of smell was better the more time had passed since they quit. The authors concluded that smoking damages the sense of smell for a long time, but these changes can be reversed.

A patient treated in Elbląg quits smoking under the care of a doctor and an addiction therapist. The doctor chooses a medicine to suit their age and health, the therapist helps them prepare for moments of tension, and the app sends reminders about doses. If the patient does not tolerate the medicine well or cravings do not ease, they do not wait for the planned follow-up appointment, but book an earlier one, including online. An appointment at the clinic at Grobla Świętego Jerzego 14A can be booked for any day of the week, between 8:00 and 20:00.