Nicotine dependence treatment Katowice

The first step is a medical appointment at Nasz Gabinet at Józefowska 76 in Katowice or online. The clinic is open every day from 8:00 to 20:00, including Saturdays and Sundays, so you can book an appointment before or after work, even if you work shifts. The first appointment costs PLN 250 at the practice and the same online, and no referral is needed.

What do we ask before choosing a medicine?

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.

What does the treatment plan include?

The patient leaves the appointment with a treatment plan. If the doctor chooses a medicine, the plan includes its name, the times to take it and the date of the last cigarette. We set the times for taking the medicine based on when the patient gets up and what shift pattern they work. Sessions with an addiction therapist take place online, and each costs PLN 250. For patients who, besides smoking, drink too much alcohol or use other addictive substances, we offer addiction therapy in Katowice.

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.

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.

Cytisine, with the dose falling from 6 to 1 or 2 tablets a day

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.

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.

A nicotine patch applied once a day

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).

Gum, spray and lozenges when a craving hits

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 and bupropion, taken twice a day

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.

A medicine eases cravings and withdrawal symptoms, but the habits that have been linked to cigarettes for years remain. These include smoking with coffee, during a break at work or in the car. In online sessions, an addiction therapist helps the patient recognise the situations in which they most often light up and decide what they will do at those moments instead of smoking. The therapist also prepares them for the possibility of smoking after a break, so that one cigarette does not mean going back to smoking every day.

Sessions with a specialist also help people who take medication. A review covered 6 studies involving 2,662 smokers, all of whom were using nicotine replacement therapy. After at least six months, about 24 percent more people who also had individual sessions were not smoking than people without such sessions. The authors rated the certainty of this result as moderate. We agree the number of sessions with the patient at the first appointment, so they know the expected cost of treatment before starting.

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.

Which symptoms can the medicine cause?

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.

Can you cough more after quitting smoking?

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.

How can you tell you are getting too much nicotine?

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.

Low mood during treatment

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.

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.

Above all, the Nasz Gabinet app reminds the patient about doses of their medicine so that none are missed. It sends a reminder for every dose at the time set in the treatment plan, so with cytisine, which is taken every 2 hours in the first days, the patient does not have to count the intervals themselves. After waking up, they see which day of treatment it is, for example day three of 25, and when the next dose is due.

From the quit date, the app also shows the number of days without cigarettes and the money not spent on cigarettes. Only the doctor changes the medicine and the times for taking it, and the patient books an appointment with the doctor, including online, in the app. We start the treatment programme in the app after you contact Nasz Gabinet Katowice, so please get in touch. We will then explain how to buy access to the programme and install the app.

• We do not recommend dietary supplements advertised as a way to quit smoking. Under the law, a dietary supplement is a food, so before going on sale it does not undergo the effectiveness testing required for medicines, and its label and advertising must not claim that it treats diseases.
• We do not suggest nicotine pouches as a replacement for cigarettes. Pouches are not a medicine and have no approved schedule for reducing the dose. The manufacturer's recommendations for NiQuitin patches, on the other hand, also cover people who want to stop using pouches.

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.

In Katowice, no patient is left to quit alone. The doctor chooses the medicine and changes the treatment plan if the medicine does not help or the patient does not tolerate it well. The addiction therapist helps the patient get through the situations in which it is hardest not to smoke, and the app sends reminders about when to take the medicine. If the first days are harder than the patient expected, they can book an earlier appointment or session, including online. The clinic at Józefowska 76 is open every day from 8:00 to 20:00.