Nicotine dependence treatment Łódź

Treatment begins with an appointment, which at Nasz Gabinet Łódź costs PLN 250, both at the practice at Rogozińskiego 23 in the Górna district and online. No referral is needed. The patient does not have to quit smoking before the appointment, because we set the date of the last cigarette only once the doctor has decided whether to treat the patient with a medicine and, if so, which one.

We assess how strong the dependence is from the number of cigarettes the patient smokes a day and how many minutes after waking up they light the first one. We also ask about e-cigarettes, heated tobacco and nicotine pouches, about the medicines used in previous attempts to quit, and about any surgery planned in the coming months, because its date affects when we set the quit date.

Before choosing a medicine, the doctor checks whether the patient has heart disease and reviews all the medicines they take, and in women also establishes whether they are pregnant or breastfeeding. This determines whether the patient can take cytisine or whether it is better to start with nicotine replacement therapy. We add sessions with an addiction therapist to the treatment; they take place online and cost PLN 250 each. In studies, talking to a therapist while taking a medicine increased the proportion of people who quit smoking. Participants in these studies usually had 4 to 8 meetings with a therapist.

Nicotine is addictive because it acts on nicotinic receptors in the brain and increases the release of dopamine, which is linked to feelings of pleasure. With regular smoking, nicotine builds up in the body over 6 to 9 hours during the day. As a result, the brain is exposed to it around the clock. Some receptors then stop responding to nicotine, and their number grows. This is how tolerance and nicotine dependence, also called nicotine addiction, develop. The World Health Organization classifies it as a disease and describes it in ICD-10 under code F17.2 and in ICD-11 under code 6C4A.2.

Smokers take in a similar amount of nicotine every day. When a cigarette contains less nicotine, for example after switching to cigarettes with a lower nicotine content, they change the way they smoke to keep the nicotine level in the body about the same. That is why lighter cigarettes do not always mean less nicotine.

People who smoke up to 5 cigarettes a day smoke mainly in particular situations, for example after a meal or when drinking, and have mild withdrawal symptoms or none at all. Even so, many of them find it hard to quit. So we talk with every patient about whether to quit overnight or gradually, however much they smoke.

Studies do not give a clear answer as to whether quitting overnight or gradually cutting down is more effective. Researchers from Cochrane, an international organisation that brings together the results of studies on a given topic, analysed 22 studies involving 9,219 smokers. There was no clear difference in the proportion of people who stopped smoking between the group that cut down before their quit day and the group that quit all at once. In a UK study of 697 smokers, one group cut the number of cigarettes by three quarters over the 2 weeks before their quit day, while the other quit overnight. After six months, 15.5 percent of people in the first group and 22 percent in the second were not smoking. That is why we suggest quitting overnight to patients who are ready to set a date for their last cigarette.

A course of cytisine gives the patient a few days to give up cigarettes. The patient starts taking the tablets while still smoking and smokes the last cigarette by day 5 at the latest, when they are already taking a tablet every 2.5 hours.

How can gum or a patch help you cut down?

Anyone who does not want to or cannot quit all at once can first cut down with the help of nicotine replacement therapy. The manufacturer of Nicorette Classic Gum allows it to be chewed between cigarettes when the urge to smoke comes, to make the gaps longer and smoke less. It also recommends trying to quit no later than 6 months after starting the gum. According to the manufacturer's recommendations, the NiQuitin Przezroczysty 21 mg patch can be applied every day for 2 to 4 weeks while the patient is still smoking, and treatment then continues without cigarettes. In the same review, cutting down with the help of a medicine led to quitting more often than cutting down without one, but the authors rate the certainty of this result as low.

Stop-smoking medicines contain one of four substances: cytisine, nicotine, varenicline or bupropion. For each of them, we give the result of a Cochrane analysis of 319 studies: the percentage of people who were not smoking after six months or longer, in groups using the medicine and in groups not using it.

Cytisine (Desmoxan, Tabex and Recigar)

Cytisine tablets and capsules contain 1.5 mg of the substance, whose current international name is cytisinicline. Cytisine stimulates nicotinic receptors in the brain more weakly than nicotine and takes nicotine's place in them, so withdrawal symptoms are milder and a cigarette smoked during treatment gives less pleasure. After six months, 13 percent of people treated with cytisine were not smoking, compared with 6 percent without medication.

Most cytisine products are sold without a prescription, and the whole course costs about PLN 40 to 78. For the first 3 days, the patient takes 6 tablets a day, and from day 21 to day 25 only 1 or 2. Cytisine is not used during pregnancy or breastfeeding or after a recent heart attack or stroke, and it is not recommended for people under 18 or over 65, because it has been poorly studied in these age groups.

Nicotine patches (NiQuitin and Nicorette Invisipatch)

A patch releases nicotine evenly through the skin throughout the day, in a smaller amount than a smoker gets from cigarettes, and in this way eases cravings. The NiQuitin patch comes in strengths of 21, 14 or 7 mg and is worn for 24 hours. Nicorette Invisipatch comes in strengths of 25, 15 or 10 mg and is worn for 16 hours. After six months, 8 percent of people using a patch were not smoking, compared with 6 percent without medication.

Patches are sold without a prescription. A full course of 24-hour patches lasts 10 weeks and costs about PLN 606 to 930, and the manufacturer advises against making it longer.

Nicotine gum, spray and lozenges

Nicorette Classic Gum contains 2 or 4 mg of nicotine per piece, Nicorette Spray 1 mg per spray, and NiQuitin MINI 1.5, 2 or 4 mg per lozenge. From these forms, nicotine is absorbed through the lining of the mouth faster than from a patch, so patients use them when a sudden urge to smoke comes, and a doctor may recommend combining them with a patch for a strongly dependent person. They are sold without a prescription. After six months, 9 percent of people using these products were not smoking.

Varenicline (Champix)

Champix is a prescription medicine containing varenicline at 0.5 or 1 mg per tablet. Like cytisine, varenicline partly stimulates nicotinic receptors and prevents nicotine from cigarettes from stimulating them fully. After six months, 14 percent of people treated with varenicline were not smoking, but in September 2026 we did not find it in the pharmacies we checked.

Bupropion (Zyban)

Zyban contained 150 mg of bupropion hydrochloride in a prolonged-release tablet and was available on prescription until its marketing authorisation expired in December 2023. Bupropion blocks the reuptake of noradrenaline and dopamine in the brain, which means nerve cells take these substances back up more slowly. According to the manufacturer, however, it is not known how the medicine makes quitting easier. After six months, 9 percent of people treated with bupropion were not smoking.

After the last cigarette, cravings set in, along with irritability, anxiety, difficulty concentrating, trouble sleeping and, in some people, low mood. These symptoms are strongest in the first week and usually pass after 2 to 4 weeks. The urge to smoke in situations associated with smoking, for example with coffee or alcohol, can still come back later, though.

A stop-smoking medicine eases withdrawal symptoms, and an addiction therapist helps plan what the patient will do when the urge to smoke is strongest. In people who have had depression, quitting smoking can make it worse. The patient tells the doctor about any marked worsening of mood and seeks medical help immediately if they have suicidal thoughts.

Yes. The longer the break from smoking before surgery, the less often complications occurred in studies. In a 2025 analysis of 55 studies, people who stopped smoking at least 4 weeks before surgery had 31 percent fewer complications overall, 29 percent fewer lung complications and 33 percent fewer wound healing complications than people who smoked right up to the operation. After at least 8 weeks without cigarettes, there were 37 percent fewer lung complications.

How a person quits also matters. In a summary of study results, the number of complications went down when support to quit started 4 to 8 weeks before surgery and included weekly sessions and nicotine replacement therapy. Brief advice before the procedure did not change the number of complications. This result, however, comes from 2 small studies.

How do we plan quitting smoking before surgery?

If the date of the operation allows, we set the quit date so that the patient has at least 4 weeks without cigarettes behind them before the procedure, and we suggest weekly sessions with an addiction therapist. When there is less time left before the operation, quitting still makes sense, because in the 2025 analysis there were already 27 percent fewer lung complications after 2 weeks without cigarettes. Before the operation, the patient tells the anaesthetist about any stop-smoking medicines, including a nicotine patch.

Does smoking slow healing after a tooth extraction?

Dry socket is a painful complication after a tooth extraction in which the blood clot falls out of the wound or breaks down. In a review of studies, smokers were more than three times as likely as non-smokers to have this complication, which occurred in about 13.2 percent of smokers and 3.8 percent of non-smokers. A patient who has a tooth extraction planned tells the dentist that they smoke.

The main job of the Nasz Gabinet app is to make sure the patient takes their medicine at the right times. During a course of cytisine, the number of tablets drops over 25 days from 6 to 1 or 2 a day, and the app reminds the patient about each tablet and shows the time of the next one. From the quit date, it also counts the days without cigarettes.

The app does not change the medicine or dose on its own. If the patient feels unwell or has symptoms they link to the medicine, they tell the doctor at an appointment booked in the app, including online, without travelling to Rogozińskiego. Please contact Nasz Gabinet Łódź, because we are the ones who start the treatment programme in the app. Over the phone, we will guide the patient through buying access to the programme and installing the app.

• We do not suggest heated tobacco as a way to quit smoking. A heated tobacco product still contains tobacco and delivers nicotine, and the WHO does not recognise it as a method that helps people stop using tobacco.
• We do not treat with acupuncture, laser therapy or electrostimulation. In an analysis of 38 studies, no reliable evidence was found for any of these methods that it helps people stay off cigarettes for six months or longer.

After quitting smoking, the risk of cancer goes down. Smoking increases, for example, the risk of mouth and throat cancer. In a meta-analysis of 115 studies, this risk was more than three and a half times higher in smokers than in people who had never smoked. The risk doubled with as few as 6 cigarettes a day or after 7 years of smoking, and after quitting it fell, halving within 10 years.

In Łódź, no patient quits alone. The doctor assesses how strong the dependence is and chooses a medicine, the addiction therapist helps the patient through the first weeks, and the app sends a reminder for every dose. When the urge to smoke is stronger than the patient expected, they can book an earlier appointment or session at the practice at Rogozińskiego 23 or online, without a referral.