Franciszka Sokoła 28, 81-603 Gdynia
Opening hours:Mon - Sun: 8:00 AM - 8:00 PM
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Nicotine from cigarette smoke reaches the brain within a few seconds. There it stimulates nicotinic receptors and increases the release of dopamine, which the smoker feels as relief or pleasure. The brain of someone who smokes every day gets used to regular doses of nicotine, so a break from smoking causes cravings and withdrawal symptoms.
In its ICD-10 classification of diseases, the World Health Organization describes the features of dependence syndrome. For nicotine dependence, also called nicotine addiction, they include:
The doctor diagnoses dependence when at least 3 of these features have occurred together for some time during the past year. In the newer ICD-11 classification, nicotine dependence has the code 6C4A.2.
The doctor assesses how strong the dependence is mainly from two answers: how many minutes after waking up the patient lights the first cigarette and how many cigarettes they smoke a day. The sooner after waking up and the more someone smokes, the more strongly dependent they usually are.
The question about the first cigarette after waking up is especially important. In an analysis of data from 4 studies comparing medicines with placebo and from one international study, the answer to this question gave a better idea of the chances of quitting than any other single measure of dependence. The answers to these questions do not replace a diagnosis, but they help the doctor choose the dose of nicotine in a patch, gum or lozenge.
Smoking also affects attendance at work. In an analysis of 29 studies of employees, smokers were absent from work an average of 2.7 days a year longer than non-smokers. Former smokers missed work less often than people who kept smoking. According to the WHO, quitting smoking also reduces the risk of impotence and difficulty getting pregnant, and in pregnant women the risk of premature birth, miscarriage and low birth weight.
Patients in Gdynia receive support throughout treatment. The doctor assesses dependence and chooses medication, adjusting treatment if it is poorly tolerated. In the treatment plan, the addiction therapist helps patients through the first smoke-free weeks, while the app provides dose reminders. If cravings or side effects are more troublesome than expected, patients arrange an earlier appointment, including by video in the app, instead of waiting for the planned date.
We see patients who want to stop smoking every day from 8:00 to 20:00 at Nasz Gabinet in Gdynia, ul. Franciszka Sokoła 28. Patients choose between two options. The Anti-Nicotine Course costs PLN 350 and includes a medical consultation and an e-prescription if the doctor considers medication necessary. The Anti-Nicotine Treatment Plan costs PLN 2499 and adds prescriptions for 3 months of medication and 10 sessions with an addiction therapist to the consultation. The course or plan is purchased in the Nasz Gabinet app, and the medicine at a pharmacy. No referral is required; consultations take place at the clinic or by video in the app. We also treat residents of Rumia, Reda, Wejherowo and Puck through the app, without travel to Gdynia.
The doctor asks how many cigarettes the patient smokes a day, how many minutes after waking up they light the first one, and whether they also use an e-cigarette or nicotine pouches. Based on this, the doctor assesses how strong the dependence is and chooses the dose of the medicine. The doctor also asks about previous attempts to quit and about side effects of the medicines the patient took then.
Before choosing a medicine, the doctor checks whether the patient has heart disease and what medicines they take regularly, and asks women about pregnancy and pregnancy plans. Tobacco smoke speeds up the breakdown of some medicines, such as clozapine and ropinirole, so after quitting their blood levels may rise. A patient taking such a medicine tells the doctor who prescribed it about the quit date.
Patients leave with treatment instructions recording the quit date and, if medication has been recommended, its name and doses. We arrange an earlier follow-up if a patient tolerates the medicine poorly or continues smoking despite taking it. People who also have difficulties with alcohol or other substances can receive addiction therapy in Gdynia.
A review of 319 studies involving more than 157,000 adults compared the effectiveness and safety of stop-smoking medicines. Serious side effects were rare, occurring on average in 3 percent of participants. It was not shown that serious side effects occurred clearly more often with cytisine, varenicline or nicotine than in people taking placebo or no medicine. The certainty of this result was, however, rated as low. With bupropion, they may affect 1 more person in 100, although this result is not certain either. Milder and more common symptoms usually appear at the start of treatment. Some of them are caused by quitting smoking itself, not by the medicine.
The Cochrane review used abstinence from smoking after at least six months as the measure of effectiveness. The differences shown compare treatment with placebo or no medicine.
In Desmoxan, Tabex and Recigar, the active substance is cytisine, now also called cytisinicline. It stimulates nicotinic receptors more weakly than nicotine, so it eases cravings. In this review, 7 more people in 100 quit smoking with cytisine than in groups without medication. Treatment lasts 25 days, and a pack for the whole course cost about PLN 40 to 78 in online pharmacies in September 2026. Most products are available without a prescription.
According to the manufacturer of Desmoxan, nausea, dry mouth, heartburn, abdominal pain, constipation or diarrhoea occur in at least 1 in 10 people. Insomnia, unusual dreams, headaches, irritability, a faster heartbeat and raised blood pressure are equally common. The manufacturer notes that these symptoms occur mainly at the start of treatment, lessen during the course, and may also result from quitting smoking itself. Cytisine must not be used during pregnancy or breastfeeding, after a recent heart attack or stroke, or in people with unstable angina or significant heart rhythm disorders. The doctor checks other contraindications before recommending it.
NiQuitin Przezroczysty is worn for 24 hours, and Nicorette Invisipatch for 16 hours, from waking up to going to bed. Nicotine from the patch is absorbed through the skin and reaches a lower blood level than after a cigarette. A patch alone increased the number of people who quit by 2 in 100. According to the manufacturer of NiQuitin patches, combining a patch with gum or lozenges may work better than a patch alone. Patches are available without a prescription. In September 2026, the patient paid about PLN 606 to 930 for 10 weeks of treatment with 24-hour patches.
The most common side effect of patches is a skin reaction where the patch is applied. It is usually mild and goes away quickly after the patch is removed. Each new patch is put on a different place, and a new patch can go on the same spot after a week at the earliest. Severe redness, itching or swelling lasting more than 4 days, or a rash or hives all over the body, are reasons to stop using the patch and talk to a doctor. With NiQuitin patches, nightmares and insomnia, headaches and dizziness, palpitations and nausea are also very common.
They can, especially at the start of treatment. The patient reaches for Nicorette Classic Gum, Nicorette Spray or NiQuitin MINI lozenges when they feel like smoking. The nicotine is absorbed in the mouth. In a summary of studies given by the manufacturer of Nicorette gum, 16.4 percent of participants reported hiccups after nicotine taken by mouth, compared with 2.3 percent in placebo groups. Hiccups were more common in studies of the spray. Throat irritation was reported by 11.8 percent of people compared with 4.4 percent on placebo, and nausea by 10.4 percent compared with 5.8 percent.
According to the manufacturer of the spray, the most common symptoms appear within the first 2 to 3 weeks and then start to ease. These forms of nicotine increased the number of people who quit by 3 in 100. None of them requires a prescription. In online pharmacies in September 2026, a pack of 105 pieces of 4 mg gum cost PLN 78 to 100, and a spray with 150 doses PLN 62 to 85.
Varenicline, found in Champix, partly stimulates nicotinic receptors, like cytisine. It increased the number of people who quit by 8 in 100. Its most common side effect is nausea. In studies in which patients took 1 mg twice a day, 28.6 percent of them had it. It usually appeared at the start of treatment, was mild or moderate and rarely led to stopping treatment. Insomnia, unusual dreams and headaches are also very common. Champix requires a prescription, and in September 2026 it was not available in the pharmacies we checked.
Bupropion, the active substance in Zyban, does not contain nicotine. It increased the number of people who quit by 3 in 100, and insomnia is a very common side effect. Rarely, in about 1 person in 1,000, it causes seizures, so it is not used in people who have or have had seizures. The marketing authorisation for Zyban expired in December 2023.
Smoking during pregnancy increases the risk of miscarriage, premature birth, low birth weight and stillbirth. The sooner a woman stops smoking, the better. An observational study from New Zealand and Australia included 2,504 women in their first pregnancy. Women who quit smoking before week 15 of pregnancy had spontaneous premature births as often as non-smokers, in 4 percent of cases. Ten percent of them had a baby that was small for gestational age, the same as among non-smokers. Among women who kept smoking, these figures were 10 and 17 percent.
Smoking also makes it harder to get pregnant. According to the manufacturer of Nicorette Invisipatch, it delays conception, reduces the success of in vitro fertilisation and increases the risk of infertility. A woman taking cytisine must use effective contraception during treatment. With systemic hormonal contraception, the manufacturer of Desmoxan also recommends a barrier method. We discuss a planned pregnancy with the patient before choosing a medicine.
Cytisine is not used during pregnancy or breastfeeding. The manufacturers of nicotine patches recommend that pregnant women quit smoking without nicotine from medicines. If a woman cannot do this, a doctor may recommend nicotine replacement therapy, and a pregnant woman starts using Nicorette Invisipatch only after consulting a doctor. According to the manufacturer of NiQuitin, the decision to use nicotine replacement therapy should be made as early as possible in pregnancy, with a course planned to last 2 to 3 months. According to the same manufacturer, gum and lozenges usually deliver less nicotine over a day than a patch, while a patch may suit a woman who has nausea.
A review of 9 studies involving 2,336 pregnant women found that nicotine replacement therapy may increase the number of women not smoking in late pregnancy, but the certainty of this result was low, and in placebo-controlled studies the difference was not clear. No differences were shown in the numbers of miscarriages, stillbirths or premature births, or in the babies' birth weight.
The evidence for talking to a specialist is stronger. A 2026 review covered 32 studies involving 12,920 pregnant women. Among women who had sessions with a counsellor, 51 percent more were not smoking at the end of pregnancy than among women receiving usual care, and the authors rated the certainty of this result as moderate. That is why, for a pregnant woman, treatment is based on sessions with an addiction therapist, and the doctor decides on nicotine from medicines.
After the first sessions, patients understand their own reasons for wanting to quit and the doubts holding them back. The therapist uses motivational interviewing for some of these conversations. Patients also understand their dependence better and have a record of the occasions when they used to smoke, such as work breaks or after meals. For each occasion, they decide what to do instead of reaching for a cigarette.
Before the quit date, the first completely smoke-free day, patients know what they will do when cravings strike. They agree the date with the doctor according to the medication schedule. With cytisine, this must be no later than day 5. In the following weeks, when withdrawal symptoms are troublesome, patients work with the therapist to find ways of managing stress and emotions without cigarettes, change daily routines and make lifestyle changes. Concerns about weight gain can also be discussed.
Later sessions help patients maintain the changes they have made and get used to thinking of themselves as non-smokers. They also agree with the therapist what they will do if they smoke one cigarette, to avoid returning to regular smoking. This work takes place during the 10 sessions included in the treatment plan, held by video in the Nasz Gabinet app. Meanwhile, the doctor assesses withdrawal symptom severity, decides on nicotine replacement therapy or cytisine, and supports the patient particularly during quitting. Follow-up dates are planned individually.
The doctor records every dose of medicine in the treatment plan, and the Nasz Gabinet app sends a reminder at the time it is due, so that the patient does not interrupt treatment. The patient confirms most doses in the app with a single tap. Once a day, the app picks one dose at random, and the patient records a video of themselves taking it on their phone, which medical staff then watch.
Patients discuss insomnia, nausea or other symptoms during treatment with the doctor through a chat e-consultation available within the programme. The doctor decides whether to change the dose. The app is free to download; patients purchase a course or treatment plan within it to access the programme. Visit Nasz Gabinet in Gdynia or call us for help installing the app, purchasing the chosen option and entering the doctor's recommendations.
Nicotine withdrawal symptoms may develop after the last cigarette. A review of tobacco withdrawal research lists anger, anxiety, low mood, difficulty concentrating, impatience, insomnia and restlessness. Symptoms peak during the first week and usually last 2–4 weeks overall. The review's author also identified constipation, cough, dizziness, more frequent dreams and mouth ulcers as possible effects of withdrawal.
Stop-smoking medication eases these symptoms, but cravings may return later in situations previously associated with smoking, such as drinking coffee or alcohol. During sessions included in the treatment plan, the addiction therapist helps patients practise waiting out these moments without a cigarette.
In a German study, the sleep of 33 smokers was tested in a sleep laboratory at three points: while smoking, 24 to 36 hours after the last cigarette and 3 months after quitting. After 24 to 36 hours without nicotine, participants woke up more often and lay awake for longer than while smoking. People who later went back to smoking were more strongly dependent than those who stayed off cigarettes and rated their sleep during withdrawal as worse. The authors concluded that sleep problems during this period may contribute to relapse.
Some stop-smoking medicines also affect sleep. The manufacturer of NiQuitin patches allows the patch to be removed before bed, but notes that a patch worn for 24 hours is better at reducing the urge to smoke after waking up. From day 4 of treatment, bupropion is taken twice a day at least 8 hours apart, and the manufacturer advises taking the second tablet earlier rather than just before bed to reduce the risk of insomnia. With cytisine, the intervals between tablets are set by the treatment schedule, so a patient who is sleeping badly does not change them on their own but tells the doctor.
The manufacturer of Desmoxan describes low mood as a possible symptom of nicotine withdrawal. Rarely, it is accompanied by suicidal thoughts or a suicide attempt, including in people quitting without medication. Quitting smoking can also make depression or another mental illness the patient had before worse. If their mood clearly worsens, the patient calls the clinic rather than waiting for the booked appointment. Suicidal thoughts need immediate medical help.
Your treatment is led by a doctor specialising in addiction medicine together with certified addiction therapists. Meet our team.
Medical doctor, addiction treatment specialist
Lek. med. Bogdan Bas has specialised in addiction treatment for over 15 years, combining medicine and psychotherapy into a modern treatment method.
Doctor of psychology, certified addiction therapist
Graduate of the University of Wrocław.
Psychologist, certified addiction psychotherapy specialist
Graduate of SWPS University of Social Sciences and Humanities.
Book your first appointment
A 3-month treatment plan for PLN 499: a medical interview in the chat, an e-prescription for the medicine and reminders for every tablet in the app. Consultations with a psychologist are paid separately.
