Józefowska 76, 40-145 Katowice
Opening hours:Mon - Sun: 8:00 AM - 8:00 PM
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After a puff of smoke, nicotine reaches the brain within a few seconds, binds to nicotinic receptors and increases the release of dopamine. In someone who smokes every day, these receptors are occupied by nicotine almost all the time and stop responding to it. The brain adapts to this state, and the World Health Organization recognises nicotine dependence, also called nicotine addiction, as a disease and describes it in ICD-10 under code F17.2 and in ICD-11 under code 6C4A.2.
During a break from smoking, for example during sleep, the receptors start responding again, and that is when cravings and withdrawal symptoms appear. The first cigarette after waking up relieves them. The sooner after waking up someone lights up, the more strongly dependent they usually are, which is why the doctor asks about this at the first appointment.
Many smokers believe that a cigarette helps them concentrate at work or calms them down under stress. A review of research on nicotine dependence suggests that better concentration and mood after smoking probably come mainly from relief of withdrawal symptoms.
Breathing improves most in the first year without cigarettes, and in the following years lung function declines more slowly than in people who keep smoking. This was shown by the US and Canadian Lung Health Study, which included smokers aged 35 to 60 with mild airway narrowing (obstruction) found on spirometry, that is, with early COPD. In participants who quit, the volume of air breathed out in the first second (FEV1) rose by an average of 47 ml in the first year without cigarettes. In the following years, FEV1 fell by an average of 31 ml a year in participants who stayed off cigarettes and by 62 ml a year in those who kept smoking, which is twice as fast.
After 5 years, people who had not smoked at all during that time least often reported chronic cough, coughing up phlegm, wheezing and shortness of breath, while people who kept smoking reported them most often. Symptoms changed mainly in the first year after quitting. The slower decline in FEV1 after quitting also applied to people who had previously smoked heavily, were older or had poor spirometry results.
Smoking tobacco is one of the main causes of death in Poland. According to the Chief Sanitary Inspectorate, about 70,000 people die because of it every year, and in an analysis cited by the Agency for Health Technology Assessment and Tariff System, smoking was responsible in 2019 for 26.6 percent of deaths among men and 13.8 percent of deaths among women. Quitting smoking reduces this risk. According to the WHO, after 10 years without cigarettes the risk of lung cancer falls to about half that of a smoker, and people who quit smoking after a heart attack halve their risk of another one.
Family members gain too. According to the WHO, other people's tobacco smoke causes more than 1.6 million deaths among non-smokers worldwide every year. When a parent stops smoking, the child's risk of respiratory diseases linked to second-hand smoke, such as asthma, and of ear infections goes down.
Patients in Katowice do not have to quit alone. The doctor selects medication and adjusts treatment if it does not help or is poorly tolerated. For patients choosing the treatment plan, the addiction therapist helps with situations in which it is hardest to resist a cigarette, while the app provides dose reminders. If the first days are harder than expected, patients can arrange an earlier appointment and, with the treatment plan, an earlier session in the app.
The first step is a medical appointment at Nasz Gabinet, ul. Józefowska 76 in Katowice, or by video in the app. The clinic is open daily from 8:00 to 20:00, including weekends, making it possible to book before or after work, including around shifts. No referral is needed. Patients purchase one of two treatment options in the app, at the same price whether the consultation is in person or by video. The Anti-Nicotine Course costs PLN 350 and includes a medical consultation with an e-prescription for the selected medicine. The Anti-Nicotine Treatment Plan costs PLN 2499 and includes the consultation, prescriptions sufficient for 3 months of treatment and 10 addiction therapy sessions. Patients buy the prescribed medicine at a pharmacy.
We ask how many cigarettes the patient smokes a day, how soon after waking up they light the first one, and whether they use an e-cigarette or heated tobacco as well as cigarettes. We also ask whether they have had a cough for months and whether they get short of breath when exerting themselves.
We check separately the medicines the patient takes regularly. Tobacco smoke speeds up the breakdown of theophylline in the liver, so after quitting smoking the blood level of this medicine, used for asthma or chronic obstructive pulmonary disease (COPD), may rise. A patient who takes theophylline tells the doctor treating their lung disease about the quit date in advance, so that the doctor can check the level of the medicine and reduce the dose if needed.
Patients leave the appointment with treatment instructions. If the doctor selects a medicine, these include its name, dosing times and the date of the last cigarette. Dosing times take account of when the patient wakes and their working pattern. Patients who also drink too much alcohol or use other addictive substances can receive addiction therapy in Katowice.
Stop-smoking medicines differ in how well they work, how much they cost and how many times a day you have to remember them. That is why we give the number of daily doses for each medicine. Prices come from online pharmacies in September 2026. None of these medicines is reimbursed by the NFZ, Poland's National Health Fund.
Desmoxan, Tabex and Recigar contain cytisine, recently also called cytisinicline, at 1.5 mg per tablet or capsule. Cytisine stimulates nicotinic receptors in the brain more weakly than nicotine, so it reduces cravings, and a cigarette smoked during treatment has a weaker effect. The number of tablets falls from 6 to 1 or 2 a day. Most products can be bought without a prescription, and one pack costing about PLN 40 to 78 is enough for the whole course. In a study carried out in Poland in 740 adult smokers who, apart from the medicine, received only brief advice, 8.4 percent of people taking cytisine and 2.4 percent of those taking placebo did not smoke for 12 months after treatment.
The manufacturer of Desmoxan gives the intervals between tablets and the maximum number of tablets a day, not clock times.
| Days of treatment | How often | Maximum per day |
|---|---|---|
1 to 3 | every 2 hours | 6 |
4 to 12 | every 2.5 hours | 5 |
13 to 16 | every 3 hours | 4 |
17 to 20 | every 5 hours | 3 |
21 to 25 | 1 or 2 tablets a day | 2 |
The level of cytisine in the blood halves after about 4 hours. The intervals between tablets and the maximum number of doses a day depend on the day of treatment and are shown in the table above. The patient takes the first tablet of the day after waking up. For shift workers, the times for taking the tablets move with the time they get up, but the number of tablets in a day must not exceed the number given in the table. The date of the last cigarette must fall no later than day 5 of treatment. A patient who smokes most at work can agree with the doctor to start treatment so that this day falls on a day off.
NiQuitin Przezroczysty and Nicorette Invisipatch deliver nicotine through the skin evenly for as long as they are worn, without the tar and carbon monoxide from smoke. The NiQuitin patch, in strengths of 21, 14 or 7 mg, is worn for 24 hours. It can be removed before bed, but a patch worn around the clock is better at curbing the urge to smoke in the morning. The Nicorette Invisipatch, in strengths of 25, 15 or 10 mg, is put on after waking up and removed after 16 hours, before going to bed. So the patient puts it on when they get up, not at a fixed time.
Patches are sold without a prescription, and a 10-week course of 24-hour patches costs about PLN 606 to 930. The international EAGLES trial enrolled 8,144 smokers with and without mental disorders. For 12 weeks, participants took varenicline, bupropion or placebo, and one group wore a 21 mg patch with the dose reduced later. The odds that a participant had not smoked in the last 4 weeks of treatment were more than twice as high with the patch as with placebo (odds ratio 2.15).
Nicorette Classic Gum (2 or 4 mg), Nicorette Spray (1 mg per spray) and NiQuitin MINI lozenges (1.5, 2 or 4 mg) deliver nicotine through the lining of the mouth faster than a patch. They are not used at fixed times, so the patient reaches for them whenever they feel like smoking, including at work. People usually chew 8 to 12 pieces of gum a day, no more than 15, for at least 3 months, and then gradually cut down.
All these forms are sold without a prescription. The patient pays PLN 78 to 100 for 105 pieces of 4 mg gum and PLN 62 to 85 for a spray with 150 doses. Cochrane is an independent scientific organisation whose reviews bring together the results of studies on a given topic. In its review, gum increased the number of people not smoking after at least six months by about half, and a patch combined with gum, spray or lozenges worked better than a single form of nicotine.
Varenicline, the active substance in Champix, acts on the same receptors as cytisine. The patient starts taking it 1 to 2 weeks before the quit date. The dose is 0.5 mg once a day for the first 3 days, 0.5 mg twice a day for the next 4 days, and then 1 mg twice a day until the end of the 12-week course. Zyban contains 150 mg of bupropion in a prolonged-release tablet. Bupropion blocks the reuptake of noradrenaline and dopamine. For the first 3 days, one tablet is taken in the morning, and after that a second one in the afternoon as well, at least 8 hours after the first and not just before bed, because insomnia is a very common side effect. Treatment with bupropion lasts at least 7 weeks.
In the EAGLES trial, the odds of not smoking in the last 4 weeks of treatment were about 3.6 times higher with varenicline than with placebo and about 1.7 times higher than with a patch or bupropion, while with bupropion they were similar to those with a patch. These figures are odds ratios, not percentages of people who quit. Champix requires a prescription, but in September 2026 we did not find it in the pharmacies we checked. Zyban was available on prescription, and its marketing authorisation expired in December 2023. That is why at Nasz Gabinet Katowice the doctor in practice chooses between cytisine and nicotine.
Medication eases nicotine cravings and withdrawal symptoms, but habits built around cigarettes over the years remain: smoking with coffee, during work breaks or in the car. These are addressed with the addiction therapist. Patients choosing the treatment plan have 10 video sessions in the Nasz Gabinet app. The Anti-Nicotine Course does not include therapy sessions.
Patients first write down their own reasons for quitting: what bothers them about smoking and what they want to gain by stopping. The therapist also helps identify doubts that have delayed that decision. One approach is motivational interviewing: the therapist asks questions, and patients find their own arguments for change in their answers. They also examine their smoking pattern, distinguishing cigarettes smoked because of cravings from those smoked out of habit, such as the first after waking or one on the way to a shift. This helps them prepare for the quit date, which the doctor aligns with the medication schedule; for cytisine, it must be no later than day 5. Patients also make a list of ways to handle cravings.
Later sessions address daily life without cigarettes: new routines around coffee and breaks, ways of managing stress and irritability, and lifestyle changes for patients concerned about weight gain. The therapist prepares patients for a possible lapse after a smoke-free period, so that one cigarette does not lead back to daily smoking. Later in therapy, patients maintain new habits and increasingly see themselves as non-smokers. Meanwhile, the doctor reviews withdrawal symptoms and whether medication needs changing. Medical support is particularly important during the quitting period, and follow-up dates are agreed individually.
Talking to a specialist also helps people taking medication. A review included 6 studies involving 2662 smokers, all using nicotine replacement therapy. After at least six months, the proportion not smoking was about 24% higher among those who also attended individual sessions than among those who did not. The authors rated the certainty of this finding as moderate.
The Nasz Gabinet app provides dose reminders at the times recorded in the treatment instructions. With cytisine, taken every 2 hours during the first few days, patients do not have to calculate the intervals themselves. On waking, they can see the current treatment day, such as day 3 of 25, and when the next dose is due.
From the quit date, the app also shows the number of smoke-free days and money not spent on cigarettes. Only the doctor changes the medicine or dosing times. Patients book appointments, including video consultations, in the app. They also purchase the course or treatment plan there; both options give access to the stop-smoking programme. Nasz Gabinet in Katowice can help with installation and purchasing.
In the first weeks without cigarettes, nicotine withdrawal symptoms appear, including cravings, irritability, anxiety, low mood, difficulty concentrating and insomnia. They are strongest in the first week and usually last 2 to 4 weeks. Some symptoms may, however, be caused by the medicine itself, so the patient describes them to the doctor.
Nausea, dry mouth, heartburn, insomnia, unusual dreams and headaches are very common side effects of cytisine. In studies, most of them appeared at the start of treatment and eased during it. These symptoms may, however, also have been caused by quitting smoking rather than by the medicine itself. Between 6 and 15.5 percent of patients stopped treatment because of side effects, similar to the groups receiving placebo.
With a nicotine patch, skin reactions where the patch is applied are the most common, and with the NiQuitin patch nightmares, insomnia, nausea and palpitations are also very common. If marked side effects with the 21 mg patch do not go away after a few days, switching to the 14 mg patch for 6 weeks and then to 7 mg for 2 weeks is recommended.
British researchers followed 174 people who were quitting smoking in a seven-week programme combining nicotine patches with counselling. After a week without cigarettes, participants reported coughing, a sore throat and sneezing more often than before they quit. A review of research on tobacco withdrawal symptoms lists coughing as a possible effect of withdrawal, and the manufacturer of NiQuitin patches includes coughing and flu-like symptoms among the complaints that can occur in people quitting smoking by any method. Coughing up blood, or shortness of breath that gets worse from day to day, needs urgent medical help, and a fever should be reported to the doctor without waiting for the end of treatment.
Signs of too high a dose of nicotine include pallor, sweating, headache, nausea and excessive salivation. Smoking while using nicotine replacement can increase the risk of overdose. If an overdose is suspected, nicotine use is stopped. A patient using a NiQuitin patch should remove it immediately and contact a doctor without delay. Further treatment is agreed with the doctor.
According to the Summary of Product Characteristics for Desmoxan, low mood can be a symptom of nicotine withdrawal, and rarely so can suicidal thoughts and suicide attempts. This also applies to people who quit smoking without medication. Quitting smoking can also make existing depression worse. A patient whose mood clearly worsens during treatment contacts the doctor straight away, without waiting for the next appointment, and suicidal thoughts need urgent 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.
