Nicotine dependence treatment Gliwice

Nicotine gives smokers more than relief and the pleasure of smoking itself. According to research, it also increases the enjoyment of things that have nothing to do with smoking, such as listening to music. Researchers believe this may be one of the reasons why smoking is so strongly linked with everyday pleasures.

The effect was first described in animals, in which nicotine increased the drive to obtain rewards unrelated to nicotine. An American study from Pittsburgh tested it in 52 smokers. Each came to the laboratory several times after a night without cigarettes and, before the task, either did not smoke, smoked a nicotine-free cigarette or smoked an ordinary cigarette with nicotine. The task involved clicking on a computer to earn money, the chance to listen to music or a break from an unpleasant noise.

After a cigarette with nicotine, participants clicked more to listen to music than after a nicotine-free cigarette or no smoking. There was no such difference for money or noise. The result was similar in people with strong and weak dependence, so it was not simply because the cigarette had eased withdrawal symptoms.

For someone who is quitting, this means that cigarettes have so far been part of many enjoyable moments, not just a way of easing nicotine cravings. With an addiction therapist, the patient lists these moments and plans how to enjoy them without a cigarette before the quit date arrives.

Yes. Tobacco smoke and harmful dust at work both damage the lungs. The effects of the two exposures add up and sometimes reinforce each other. This applies in particular to lung cancer in people exposed to asbestos and to chronic obstructive pulmonary disease, or COPD, in people who work with dust, gases and fumes.

An American study compared 2377 insulators, workers who install insulation containing asbestos, with more than 54 thousand workers who did not work with asbestos. In non-smoking insulators, the risk of death from lung cancer was 3.6 times higher than in non-smoking workers with no asbestos exposure, and in smoking workers with no asbestos exposure it was 10.3 times higher. In smoking insulators, it was 14.4 times higher. The highest risk, almost 37 times higher, was in smoking insulators in whom asbestos had already caused lung fibrosis, known as asbestosis.

Quitting smoking helped in this group too. Within 10 years of quitting, lung cancer mortality among insulators fell by half, and after 30 years it approached that of people who had never smoked.

Another US study compared 1202 people with COPD with 302 people without the disease. Work involving dust, gases, vapours or fumes in the job participants had held longest roughly doubled the risk of COPD, even after taking smoking into account. In people who smoked and also worked in such conditions, the risk was 14 times higher than in non-smokers without such exposure.

A patient who works or has worked in a dusty factory hall, in a mine or with asbestos tells the doctor about it at the first appointment. The doctor assesses whether lung tests, such as spirometry, are needed.

Quitting smoking reduces the risk of bladder cancer. Carcinogens from tobacco smoke pass into the blood, the kidneys excrete them in urine, and the urine collecting in the bladder is in contact with its wall.

More than 467 thousand American women and men aged 50 to 71 completed a questionnaire about smoking, and researchers then tracked for about 11 years who developed the disease. Smokers developed bladder cancer about 4 times as often as people who had never smoked, and former smokers about 2 times as often. According to the authors, smoking accounted for roughly half of all cases, in both men and women. An analysis of 89 studies, in turn, shows that the increased risk persists long after quitting, and people who stopped smoking at least 20 years before diagnosis benefit the most.

Patients at Nasz Gabinet in Gliwice do not have to quit alone. If medication causes problems or fails to control cravings, the doctor changes the dose or medicine. Patients choosing the treatment plan also work with an addiction therapist on handling situations where they used to smoke. Medical staff can see in the app whether doses are being taken.

Treatment for nicotine dependence, also called nicotine addiction, starts with a consultation at ul. Toszecka 18 in Gliwice or by video in the Nasz Gabinet app. No referral is needed, and appointments are available every day between 8:00 and 20:00. Patients choose one of two options in the app. The Anti-Nicotine Course costs PLN 350 and includes a consultation at which the doctor selects medication and issues an e-prescription. The Anti-Nicotine Treatment Plan costs PLN 2499 and includes a consultation, prescriptions for 3 months of medication and 10 sessions with an addiction therapist. The medicine is paid for separately at the pharmacy.

The doctor asks how much and how long the patient has smoked, and whether they also use e-cigarettes or heated tobacco. They ask about health conditions, regular medication and working conditions, such as exposure to dust, exhaust fumes or asbestos. This information helps the doctor choose cytisine or nicotine medication, set the doses and agree the date of the last cigarette with the patient. At follow-up, the doctor asks whether the patient has smoked and whether the medicine is causing symptoms, adjusting the dose if necessary.

Most stop-smoking medicines act on nicotine receptors in the brain, but in two different ways. Cytisine and varenicline occupy these receptors and stimulate them more weakly than nicotine, while nicotine medicines deliver nicotine without smoke. We give the effectiveness of medicines according to the 2023 Cochrane review, which covered 319 studies. Cochrane is a network of researchers who do not test medicines themselves, but find all the studies on a given treatment and summarise their results. The amounts given are medicine prices offered by the pharmacies we checked in September 2026.

In the Cochrane review, the effectiveness of medicines 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.

How does cytisine help people stop smoking?

Cytisine is a plant substance with a structure similar to nicotine, found in Desmoxan, Tabex and Recigar. It binds to nicotine receptors more strongly than nicotine, so over time it takes nicotine's place, although it stimulates the receptors more weakly. According to the manufacturer of Desmoxan, this prevents nicotine from fully stimulating the brain's reward system, and by moderately increasing dopamine levels it eases withdrawal symptoms.

The course lasts 25 days. From day 1 to day 3, one tablet is taken every 2 hours, up to 6 tablets a day. On the following days the intervals get longer, and the patient smokes their last cigarette no later than day 5 of treatment. For every 100 people treated with cytisine, about 7 more stopped smoking than without medication. The 25 days require 100 tablets, which is one pack costing PLN 40 to PLN 78.

Do varenicline and bupropion work in a similar way?

Varenicline, the active substance in Champix, works like cytisine. It stimulates nicotine receptors more weakly than nicotine and makes it harder for nicotine from a cigarette to reach them, which, according to the manufacturer, reduces the pleasure of smoking. With varenicline, about 8 more people per 100 treated quit smoking than without medication. Bupropion, the active substance in Zyban, inhibits the reuptake of noradrenaline and dopamine by nerve cells, and the manufacturer notes that it is not known exactly how it helps people quit. With bupropion, about 3 more people per 100 treated quit smoking than without medication.

Both medicines are prescription-only. Zyban has had no marketing authorisation since the end of 2023, and in September 2026 Champix was not available in any pharmacy we checked. In practice, therefore, a patient in Gliwice is recommended cytisine or a nicotine medicine.

What does nicotine from a patch, gum or spray do?

Nicotine medicines deliver nicotine without tobacco smoke and do not make it harder for nicotine from a cigarette to reach the receptors. That is why, from the quit date, the patient does not light a single cigarette. The same Pittsburgh team tested whether nicotine from medicines also enhances other rewards. After a night without cigarettes, smokers received a nicotine patch or nicotine nasal spray and were more willing to work for the chance to watch a film than after a placebo. The authors suggest this may be one of the reasons why nicotine medicines help people quit smoking.

The NiQuitin Przezroczysty patch is worn around the clock. A person who smokes more than 10 cigarettes a day starts with a 21 mg patch for 6 weeks, then applies a 14 mg patch for 2 weeks and a 7 mg patch for 2 weeks. The Nicorette Invisipatch patch is removed before going to bed, after 16 hours. With a patch alone, about 2 more people per 100 treated quit smoking than without medication, and NiQuitin patches for 10 weeks cost from about PLN 606 to PLN 930.

When the urge to smoke comes on suddenly, the patient reaches for a NiQuitin MINI lozenge, Nicorette Spray mouth spray or Nicorette Classic Gum. Usually 8 to 12 pieces of gum or lozenges a day are enough, and no more than 15 can be used. No more than 2 sprays are taken at a time and 4 within an hour, with no more than 64 a day. For fast-acting forms of nicotine, the combined result was about 3 extra non-smokers per 100 compared with placebo or no medicine. Combining one of these forms of nicotine with a patch gave an effect close to that of cytisine treatment. The cheapest 150-dose spray we found cost PLN 62 and the most expensive PLN 85. For 105 pieces of 4 mg gum, you had to pay at least PLN 78, and PLN 100 in more expensive pharmacies.

Medication reduces nicotine cravings. With an addiction therapist, patients learn to change habits linked to smoking after lunch, while driving or in front of the television. They work on this in the 10 video sessions in the Nasz Gabinet app included in the treatment plan. The PLN 350 course does not include these sessions.

The first conversations explore why patients smoke and why they themselves want to stop. The therapist helps them identify their own reasons and consider their doubts. One approach is motivational interviewing, in which patients weigh their own arguments for and against change. Together, they then examine a typical day: when, where and in what mood a cigarette appears. This provides the basis for a quit-day plan aligned with the medication selected by the doctor; with cytisine, the last cigarette must be no later than day 5 of treatment. They also plan how to handle cravings that return despite medication.

In later sessions, patients change daily routines, such as how they spend a work break, and learn to manage stress and anger without cigarettes. If they are worried about weight gain, they discuss lifestyle changes with the therapist. Later work focuses on maintaining new habits, becoming comfortable with being a non-smoker, and planning what to do after smoking one cigarette so that a lapse does not become a return to smoking. Meanwhile, the doctor assesses nicotine withdrawal symptoms, offers support particularly during quitting, and agrees follow-up dates individually. Read more on our page about addiction therapy in Gliwice.

We enter the name of the medicine and the dose times from the treatment plan into the Nasz Gabinet app, and it reminds the patient about every cytisine tablet and every patch. A single tap on the screen confirms that a dose has been taken. Every day, the app randomly chooses the dose for which it will ask for a short video recording, and the recording is reviewed by medical staff. Recordings do not apply to medicines for sudden cravings, that is, gum, spray and lozenges.

The app also has an emotions diary. At midday and in the evening, it invites patients to record an emotion, its intensity and what triggered it. Entries are private by default, and patients choose which ones to share with clinic staff. After a few weeks, it becomes easier to see which moods most often accompany cravings.

The app itself is free. Patients purchase a course or treatment plan within it; either option gives access to the stop-smoking programme. For help with purchasing or installation, visit the clinic at ul. Toszecka 18 or call us.

• We do not suggest switching from cigarettes to heated tobacco. In such a device, tobacco does not burn but is heated and releases an aerosol containing nicotine. In a review of 13 studies published in 2022, no study tested whether heated tobacco helps people quit smoking, and all the randomised trials were funded by tobacco companies. People who switched to heated tobacco absorbed fewer carcinogens than cigarette smokers, but more than people who tried not to use tobacco at all. They still took in nicotine, however, which keeps the dependence going.
• We do not agree with patients that smoking less is enough. Fewer cigarettes can be a step towards the quit date, but it is not the goal of treatment. A Danish study followed 19,732 people for an average of 15.5 years. Smokers of at least 15 cigarettes a day who cut that number by half or more died of heart and blood vessel disease, lung disease and smoking-related cancers about as often as people who continued to smoke heavily. In people who quit smoking, the risk of death was clearly lower in most comparisons.