What does treatment in Kielce involve, from the first appointment to the end of treatment?
At the first appointment, the doctor asks how many cigarettes the patient smokes, how soon after waking up they light the first one, whether they also use an e-cigarette or nicotine pouches, what conditions they have and what medicines they take. Based on this, the doctor decides whether to recommend a medicine and, if so, which one. The medicine chosen also determines when the quit date falls.
Between appointments, the patient takes the medicine according to the plan. During treatment with cytisine or a nicotine patch, the Nasz Gabinet app reminds them about doses. In sessions with an addiction therapist, which take place online and cost PLN 250, the patient prepares for the situations in which they used to reach for a cigarette. We set the number of sessions and follow-up appointments in the treatment plan, because it depends on the medicine, how treatment goes and whether the patient has smoked after the quit date. For a patient who also has a problem with alcohol or medicines, we offer addiction therapy in Kielce.
How can you reduce the risk of going back to smoking after treatment ends?
The manufacturers of Nicorette Invisipatch, nicotine gum and nicotine spray note that some former smokers need longer treatment to avoid going back to smoking. According to the manufacturer of varenicline, the risk of relapse rises just after treatment ends, and for someone who is not smoking after 12 weeks of treatment, the doctor may recommend another 12 weeks. Before treatment ends, we discuss with the patient what they will do if they want to smoke again after stopping the medicine.
Where do we see patients in Kielce?
Nasz Gabinet Kielce at Wspólna 7 is open every day, including Saturdays and Sundays, from 8:00 to 20:00. The first appointment for nicotine dependence treatment costs PLN 250 at the practice and the same online, and no referral is needed. We also see patients from Ostrowiec Świętokrzyski, Starachowice, Skarżysko-Kamienna, Busko-Zdrój and Jędrzejów online.
Why do cravings come back several times a day?
Nicotine from smoke reaches the brain within a few seconds, binds to nicotinic receptors and increases the release of dopamine, which the smoker feels as pleasure or relief. Between cigarettes, its blood level rises and falls noticeably. When it falls, a dependent person feels a craving and reaches for the next cigarette. The World Health Organization classifies nicotine dependence, also called nicotine addiction, as a disease, under code F17.2 in ICD-10 and under code 6C4A.2 in ICD-11.
With regular smoking, the brain adapts to nicotine. Some receptors stop responding to it, and their number grows. During a break from smoking, the receptors start responding again, and that is when withdrawal symptoms get stronger.
Nicotine medicines deliver nicotine more slowly than a cigarette. A patch keeps the nicotine level roughly steady for 24 or 16 hours, while gum, spray and lozenges help when a sudden craving hits. Too low a dose of nicotine from a medicine may not ease cravings, and too high a dose causes symptoms of too much nicotine, which is why the doctor sets the dose.
How do stop-smoking medicines differ and when should you start taking them?
Stop-smoking medicines differ in their ingredients, how they work, their price and when the quit date falls. The patient starts taking cytisine, varenicline and bupropion while still smoking, whereas a nicotine patch is usually put on after the last cigarette. We give effectiveness according to reviews by Cochrane, an independent scientific organisation that brings together the results of studies on one topic. The figures show how many more people were not smoking after at least six months than in comparison groups, not what share of patients quit.
Cytisine, with quitting by day 5 of treatment at the latest
Cytisine is the active substance in Desmoxan, Tabex and Recigar, in 1.5 mg tablets. It acts on the same receptors in the brain as nicotine but stimulates them more weakly, so it eases cravings and reduces the pleasure of smoking. A pack of Desmoxan contains 100 tablets for 25 days of treatment. For the first 3 days, the patient takes one tablet every 2 hours, up to 6 tablets a day, then less and less often, and in the last 5 days 1 or 2 tablets a day. They give up cigarettes by day 5 of treatment at the latest and do not smoke until the end, because smoking during treatment can make side effects worse. In 4 studies involving 4,623 people, 30 percent more people taking cytisine than people in the placebo group were not smoking. Most cytisine products are available without a prescription, and in September 2026 a pack for the whole course cost about PLN 40 to 78.
Varenicline, with quitting usually between day 8 and day 14
Varenicline, the active substance in Champix, acts on nicotinic receptors in a similar way to cytisine. On days 1 to 3, the patient takes a 0.5 mg tablet once a day, on days 4 to 7 twice a day, and from day 8 until the end of the 12-week course a 1 mg tablet in the morning and evening. The quit date is usually set in week 2 of treatment. A patient who does not want to or cannot set it that early can choose their own date within 5 weeks of starting treatment. In 41 studies, varenicline more than doubled the number of non-smokers. The medicine requires a prescription, but in September 2026 we did not find it in the pharmacies we checked.
Bupropion, with quitting in week 2 of treatment
Bupropion, the active substance in Zyban, in 150 mg tablets, is an antidepressant that contains no nicotine. Treatment starts while the patient is still smoking, and the quit date is planned within the first 2 weeks, preferably in the second. For 3 days, the patient takes one tablet in the morning, and from day 4 a second one as well, at least 8 hours after the first. Insomnia is a very common side effect, so the second tablet is not taken just before bed. In 45 studies, 64 percent more people were not smoking than in placebo or no-treatment groups. The medicine requires a prescription, and the marketing authorisation for Zyban expired in December 2023.
A nicotine patch from the quit date
NiQuitin Przezroczysty and Nicorette Invisipatch release nicotine through the skin, without the tar and carbon monoxide from smoke. For people quitting overnight, the manufacturer of NiQuitin patches recommends stopping smoking before putting on the first patch. The patch is applied once a day, in the morning after waking up. A course of NiQuitin patches usually starts at 21 mg for 6 weeks, followed by 2 weeks at 14 mg and 2 weeks at 7 mg. A person who smokes no more than 10 cigarettes a day starts at 14 mg. Nicorette Invisipatch, in strengths of 25, 15 and 10 mg, is worn for 16 hours and removed before bed. Patches increased the number of non-smokers by 64 percent compared with placebo or no treatment. They are sold without a prescription, and 10 weeks of treatment with NiQuitin patches cost about PLN 606 to 930 in September 2026.
Gum, spray and lozenges, including while cutting down
Nicorette Classic Gum in 2 and 4 mg strengths, Nicorette Spray at 1 mg per spray and NiQuitin MINI lozenges deliver nicotine through the lining of the mouth whenever the patient feels like smoking. The manufacturers intend the 4 mg gum and lozenges for people who smoke more than 20 cigarettes a day, and the 4 mg gum also for a Fagerström test score of 6 points or more. People usually use 8 to 12 pieces of gum or lozenges a day and should not go above 15. No more than 2 sprays should be used at a time, 4 sprays an hour and 64 sprays a day. The manufacturers of the gum and spray also describe using them while cutting down, before quitting completely.
Gum increased the number of non-smokers by 49 percent and lozenges by 52 percent compared with placebo or no treatment. All these forms are available without a prescription. In September 2026, 105 pieces of 4 mg gum cost PLN 78 to 100, and a spray with 150 doses PLN 62 to 85.
What can you expect in the first weeks after quitting smoking?
After quitting smoking, anger, anxiety, low mood, difficulty concentrating and insomnia are strongest in the first week and usually last 2 to 4 weeks. During this time, cravings come back several times a day, most often in situations in which the patient used to smoke. A stop-smoking medicine eases these symptoms.
In online sessions, the addiction therapist agrees with the patient what they will do in such situations, for example with their morning coffee, during a break at work or after an argument. A patient who smokes after the quit date does not stop treatment on their own, but tells the doctor or therapist, because the plan for further appointments and sessions depends on it. If their mood clearly worsens, they contact the doctor without waiting for the booked appointment, and suicidal thoughts need immediate medical help.
What should you do after a missed dose, too high a dose or too low a dose?
A missed dose is not made up with a double dose. If there are symptoms of too much nicotine, the patient stops taking it and contacts the doctor, and if cravings are strong despite treatment, the doctor checks whether the dose is too low. The details depend on the medicine.
What should you do after missing a dose?
According to the manufacturer of varenicline, taking all doses at the right time throughout the recommended period increases the chance of quitting. The patient takes a forgotten Champix tablet as soon as they remember, unless the next dose is due within 3 to 4 hours. In that case, they skip the missed tablet and do not take a double dose. Bupropion is not taken at more than 150 mg at a time, and at least 8 hours must pass between two doses, so two Zyban tablets are not combined into one dose.
The Summary of Product Characteristics for Desmoxan does not say what to do after missing a cytisine tablet. The treatment schedule does, however, give the maximum daily dose, for example 6 tablets on days 1 to 3 and 5 tablets on days 4 to 12, and the patient does not exceed this dose. The patient talks to a doctor or pharmacist about how to continue cytisine after missing several tablets.
A NiQuitin patch is applied once a day, always at the same time, and not worn for longer than 24 hours, because after that it releases less nicotine. Two patches are never applied at the same time, even if the patient is late changing it. The patient does not use gum, spray or lozenges at fixed times, but when a craving hits, and keeps to the daily limit.
What symptoms suggest too high a dose of nicotine?
According to the manufacturers of nicotine replacement products, symptoms of too high a dose of nicotine can occur in a person who took in little nicotine before treatment, and in a person who takes in nicotine from other sources during treatment, for example by still smoking or using an e-cigarette. The symptoms are similar to those of nicotine poisoning. They include:
- nausea, vomiting and excessive salivation
- abdominal pain and diarrhoea
- pallor and heavy sweating
- headache and dizziness
- hearing disturbances and marked weakness
A patient with such symptoms stops taking nicotine and does not wait for a scheduled appointment, but contacts the doctor straight away. They remove the patch and rinse the skin with plain water, because according to the manufacturer of NiQuitin patches, soap can increase nicotine absorption. Nicotine stored in the skin keeps passing into the blood for several hours after the patch is removed, so symptoms may not go away immediately. Low blood pressure, a weak or irregular pulse, difficulty breathing, extreme exhaustion and seizures can occur after a large dose of nicotine and need immediate medical help.
The manufacturer of the gum and of Nicorette Invisipatch recommends stopping nicotine for a while if there are symptoms of too high a dose, and if they do not go away, using the medicine less often or at a lower dose. If marked side effects do not go away a few days after starting treatment with the NiQuitin 21 mg patch, the manufacturer recommends lowering the dose to 14 mg. The doctor agrees the new dose with the patient.
Can you overdose on cytisine?
Cytisine does not contain nicotine, but according to the manufacturer of Desmoxan, the symptoms of a cytisine overdose are similar to those of nicotine poisoning. They include feeling unwell, nausea, vomiting, a fast heartbeat, changes in blood pressure, breathing and vision problems, and seizures. A patient who has taken more tablets than the treatment schedule allows and has such symptoms needs urgent medical help.
When might the dose of nicotine be too low?
Strong cravings despite treatment may mean the dose of nicotine is too low, but the doctor also checks whether the patient is using the medicine correctly, for example whether they chew the gum as the manufacturer recommends. If a craving does not pass within a few minutes after one spray, the manufacturer allows a second spray. For people who have not stopped smoking while using 2 mg gum, the manufacturer recommends 4 mg gum. For someone for whom a patch alone is not enough, gum, a lozenge or nicotine spray can help with sudden cravings. Such a combination, a higher dose or a change of medicine is decided by the doctor, especially for a person with heart disease, and two patches are never applied at the same time.
How does the Nasz Gabinet app remind you about doses?
The Nasz Gabinet app sends a reminder for every dose of cytisine and for putting on a patch, according to the plan agreed at the appointment, and the patient sees the next dose on the home screen. This helps especially in the first days of cytisine treatment, when a tablet is taken every 2 hours. From the quit date, the app also shows the money the patient has not spent on cigarettes.
The app does not change the medicine or the dose. A patient who misses doses several days in a row tells the doctor and books an appointment in the app, including online. We activate the treatment programme in the app after you talk to Nasz Gabinet Kielce. Please contact us by phone or in person. We will then agree how to buy access to the programme and install the app.
Which stop-smoking methods do we not use?
- We do not recommend anti-anxiety medicines instead of stop-smoking medicines. In a review of studies on diazepam, meprobamate, buspirone, metoprolol and oxprenolol, none of these medicines clearly helped people stop smoking, although there were few studies. Diazepam is a benzodiazepine, which can itself cause dependence.
- We do not recommend tablets or drops sold as dietary supplements for quitting smoking. Under food law, a supplement is a food, so it does not undergo the effectiveness testing required for medicines, and its manufacturer may not claim that it treats diseases.
Why start nicotine dependence treatment in Kielce?
For the heart, what counts is quitting completely, not just smoking fewer cigarettes. In an analysis of 141 studies, the extra risk of coronary heart disease in men who smoked one cigarette a day was almost half the extra risk in men who smoked 20 cigarettes a day. In women, it was about a third. The authors of the analysis concluded that there is no level of smoking that is safe for the heart and blood vessels.
According to Statistics Poland (GUS), a pack of 20 cigarettes cost PLN 21.61 on average in 2025, compared with PLN 17.24 two years earlier. A person who smokes a pack a day spends about PLN 7,888 a year on cigarettes, and a person who smokes 10 cigarettes a day about PLN 3,944. Over 10 years, even if prices stayed the same, that comes to about PLN 78,900 and PLN 39,400 respectively.
The first appointment at Nasz Gabinet Kielce costs PLN 250, and a course of cytisine about PLN 40 to 78. Together, that is less than a person who smokes a pack a day spends on cigarettes in 16 days.
Our team helps patients from Kielce and the surrounding area to quit smoking. The doctor chooses the medicine and dose, the addiction therapist prepares the patient for the situations in which they smoked most often, and the app sends reminders about doses. If the patient needs an earlier appointment or session, they book it at the practice at Wspólna 7, which is open every day from 8:00 to 20:00, or online.
