Nicotine dependence treatment Lublin

The addictive substance in cigarettes is nicotine, which stimulates nicotinic receptors in the brain and increases the release of dopamine, which is linked to pleasure and reward. With daily smoking, the brain adapts to nicotine, and without it cravings and withdrawal symptoms appear. The World Health Organization describes nicotine dependence as a disease in ICD-11 under code 6C4A.2, regardless of whether the nicotine comes from a cigarette or an e-cigarette.

From smoke inhaled into the lungs, nicotine reaches the brain within a few seconds. The smoker clearly feels this effect after every puff, which reinforces the dependence, and the nicotine level in the blood rises and falls sharply between cigarettes. According to a review of research on nicotine dependence, other components of smoke that block enzymes in the brain that break down dopamine, as well as additives and the design of cigarettes, also contribute to dependence.

Patches, gum, spray and lozenges deliver nicotine more slowly than a cigarette, so the risk of misusing them is low. They ease withdrawal symptoms without the patient inhaling smoke.

In a Polish study of 992 fifteen-year-olds, bleeding gums were found in 25.1 percent of the students. Of them, 7.2 percent smoked cigarettes and 11.7 percent used e-cigarettes. After taking into account factors such as daily oral care habits, smoking cigarettes was linked to a more than two and a half times higher chance of bleeding gums, and using e-cigarettes to an almost twice as high chance. This was a cross-sectional study, so it does not prove that cigarettes and e-cigarettes caused the bleeding.

In a review of studies of adolescents and young adults, the authors rated the certainty of the findings on e-cigarettes and oral health as low, partly because many people also smoked ordinary cigarettes.

Among students, e-cigarettes are now more popular than cigarettes. In the 2024 nationwide ESPAD survey, 37.2 percent of students aged 15 and 16 and 50.9 percent of those aged 17 and 18 had used e-cigarettes in the previous 30 days, while 21 and 30 percent respectively had smoked cigarettes in that time. Since July 2025, it has been illegal to supply e-cigarettes or nicotine pouches to anyone under 18.

According to WHO, circulation and lung function improve 2–12 weeks after the last cigarette, while cough and breathlessness decrease within 1–9 months. After 15 smoke-free years, coronary heart disease risk is the same as in someone who has never smoked. WHO estimates that quitting at around age 40 adds about 9 years of life.

People who are already ill also benefit from quitting. In observational studies, patients with heart or blood vessel disease who stopped smoking had a 39 percent lower risk of dying from cardiovascular causes than those who kept smoking. There is money left over too. A pack of cigarettes cost PLN 21.61 on average in 2025, so a person who smokes half a pack a day spends more than PLN 300 a month on cigarettes.

At Nasz Gabinet in Lublin, patients do not have to quit alone. The doctor selects medication and checks how it is tolerated, while the app provides dose reminders. Patients choosing the Anti-Nicotine Treatment Plan also work with a therapist on managing difficult situations. If strong cravings return during the first weeks, patients can bring forward a medical appointment or therapy session. Consultations take place at the clinic or by video, and therapy sessions in the app. We are open daily from 8:00 to 20:00 at ul. Narutowicza 78A, unit 3; no referral is needed.

Yes. A medicine eases cravings and withdrawal symptoms, and an addiction therapist teaches the patient how to cope with situations in which they used to reach for a cigarette. A review covered 52 studies involving 19,488 smokers. After at least six months, the proportion of non-smokers was almost twice as high in the group that received medication and had several sessions with a stop-smoking specialist as in the group that received only brief advice or usual care. The authors rated the quality of this evidence as high.

In Lublin, we therefore offer a treatment plan that goes beyond prescribing medication. The doctor chooses the medicine and dose, while patients who choose the plan also meet an addiction therapist. If cravings are stronger than expected during treatment, the doctor assesses whether to change the dose or medicine.

Treatment starts with a medical appointment at Nasz Gabinet in Lublin, ul. Narutowicza 78A, unit 3, or by video in the app, without a referral. Patients purchase one of two options in the app. The Anti-Nicotine Course costs PLN 350 and consists of a consultation at which the doctor issues an e-prescription. The Anti-Nicotine Treatment Plan costs PLN 2499 and includes the consultation, prescriptions for 3 months of medication and 10 video sessions with an addiction therapist. The doctor assesses whether medication is needed and agrees a quit date with the patient. The clinic is open daily from 8:00 to 20:00.

What should you tell the doctor at the first appointment?

We ask how many cigarettes the patient smokes a day, how soon after waking up they reach for the first one, and whether they have tried to quit before. If they have, we want to know whether they used a medicine at the time and how long it was before they went back to cigarettes. We also ask about e-cigarettes, hookah and hand-rolled cigarettes with tobacco, because nicotine from any of these products affects the choice of medicine and dose.

The doctor also asks about chronic conditions and medicines taken regularly. Cytisine is not used, among other situations, after a recent heart attack or stroke, in unstable angina or in clinically significant heart rhythm disorders. A patient who has recently been in hospital brings their discharge summary and the list of medicines prescribed on discharge.

What does the patient receive after the appointment?

The appointment ends with treatment instructions specifying the quit date and, if the doctor recommends medication, the doses and treatment start date. We treat residents of Chełm, Zamość and Biała Podlaska through the app without travel to Lublin. Patients also dependent on alcohol can receive addiction therapy in Lublin.

Cytisine for 25 days

Cytisine is the active substance in Desmoxan, Tabex and Recigar. In these products, a tablet or capsule contains 1.5 mg of cytisine. It stimulates the same receptors in the brain as nicotine but more weakly, so it eases cravings, and a cigarette smoked during treatment gives less pleasure. One pack of Desmoxan contains 100 tablets and is enough for the whole course. For the first 3 days, the patient takes 6 tablets a day, in the last 5 days 1 or 2, and stops smoking by day 5 at the latest.

In an analysis of 4 studies involving 4,623 people, 30 percent more people taking cytisine than people given placebo were not smoking after at least six months. Most cytisine products are available without a prescription, and in September 2026 a pack for the whole course cost about PLN 40 to 78 in online pharmacies.

Nicotine patches for 8 to 12 weeks

A patch releases nicotine, which is absorbed through the skin. It does not deliver the tar or carbon monoxide found in smoke. How long treatment lasts depends on the manufacturer. The NiQuitin patch is worn for 24 hours at a time, at 21 mg for 6 weeks, and then at 14 mg and 7 mg for 2 weeks each. For people who smoke no more than 10 cigarettes a day, treatment starts at 14 mg and lasts 8 weeks, and the manufacturer does not recommend extending it. Nicorette Invisipatch is put on in the morning and taken off before bed. A strongly dependent person wears it at 25 mg for 8 weeks, and then at 15 mg and 10 mg for 2 weeks each, so treatment lasts 12 weeks.

In a summary of studies, patches increased the number of non-smokers by 64 percent compared with placebo or no treatment. However, a 2023 review found no clear evidence that wearing patches for longer increases the chance of quitting. Patches are sold without a prescription, and 10 weeks of treatment with 24-hour patches cost about PLN 606 to 930 in September 2026.

Gum, spray and lozenges for about 3 months

The patient uses Nicorette Classic Gum, Nicorette Spray and NiQuitin MINI lozenges whenever they feel like smoking, and the nicotine is absorbed through the lining of the mouth. Nicotine gum is used for at least 3 months and then gradually stopped. The spray is used at the full dose for 6 weeks, the number of doses is halved by the end of week 9, and in week 12 the patient uses no more than 4 doses a day. Lozenges are taken for 6 weeks and then less and less often, down to 1 or 2 a day.

Among people chewing gum, there were 49 percent more non-smokers than in comparison groups, and among people using lozenges 52 percent more. All these forms are available without a prescription. The patient paid PLN 78 to 100 for 105 pieces of 4 mg gum and PLN 62 to 85 for a spray with 150 doses.

Varenicline for 12 or 24 weeks

Varenicline, the active substance in Champix, in 0.5 and 1 mg tablets, acts on nicotinic receptors in a similar way to cytisine. The patient usually starts taking it 1 to 2 weeks before quitting. Treatment lasts 12 weeks. For someone who has stopped smoking during that time, the doctor may recommend another 12 weeks. In 2 studies involving 1,297 such people, continuing varenicline increased the number who did not go back to smoking by 23 percent. In 41 studies, varenicline more than doubled the number of non-smokers. It requires a prescription, but in September 2026 we did not find it in the pharmacies we checked.

Bupropion for at least 7 weeks

Bupropion, the active substance in Zyban, in 150 mg tablets, is an antidepressant that contains no nicotine. The patient starts taking it while still smoking, stops smoking within the first 2 weeks of treatment and takes the medicine for at least 7 weeks. In 45 studies, 64 percent more people were not smoking after treatment with bupropion than in placebo or no-treatment groups. The marketing authorisation for Zyban expired in December 2023.

The Anti-Nicotine Treatment Plan at Nasz Gabinet in Lublin includes 10 addiction therapy sessions by video in the app. The Anti-Nicotine Course does not include these sessions. At the first sessions, patients examine when, with whom and in which circumstances they smoke. Every nicotine product matters, including e-cigarettes, a weekend waterpipe with friends and cannabis joints mixed with tobacco. This helps identify the situations in which it will be hardest not to smoke.

Patients then discuss their own reasons for quitting and their doubts with the therapist. The therapist may use motivational interviewing to help patients consider their reasons for continuing to smoke and their reasons for change. Next comes preparation for the quit date, the first completely smoke-free day. We align it with the prescribed medication schedule, so people taking cytisine stop smoking by day 5 at the latest. Patients reach this day with a plan for what to do when cravings occur.

After quitting, sessions address everyday life: routines previously associated with cigarettes, stress, emotions, lifestyle changes and concerns about weight gain. In the final stage of therapy, patients maintain new habits, begin to think of themselves as non-smokers, and discuss how to respond to a single cigarette so a lapse does not become a relapse. During consultations, the doctor assesses withdrawal symptoms and selects nicotine replacement therapy or cytisine. Medical support is particularly important during quitting. Follow-ups are scheduled according to each patient's circumstances.

The Nasz Gabinet app sends a reminder for every dose the doctor has set out in the treatment plan, so that the patient takes the medicine regularly throughout treatment. With a nicotine patch, the dose goes down every few weeks, for example from 21 mg to 14 mg, and the app shows the dose for the current stage, so the patient does not have to work it out themselves.

The app also shows smoke-free days and money not spent on cigarettes. Only the doctor changes doses, so patients who notice insomnia after using a patch, for example, book an appointment in the app, including by video. They also purchase the course or treatment plan there; either option gives access to the stop-smoking programme. Contact Nasz Gabinet in Lublin for help installing the app and completing the purchase.

A patient is also taking in nicotine when they use an e-cigarette with a nicotine liquid, smoke tobacco in a hookah or smoke joints with tobacco. At the appointment, we ask about each of these, for example how many millilitres of e-liquid the patient uses and what nicotine strength it has.

The dose of a nicotine medicine depends on how strong the dependence is. According to the manufacturer, NiQuitin MINI 4 mg lozenges are intended for people who smoke more than 20 cigarettes a day. A strongly dependent person starts a course of Nicorette Invisipatch at 25 mg per 16 hours, and a less dependent person at 15 mg. For a patient who also uses an e-cigarette or a hookah, the doctor therefore does not rely on the number of cigarettes alone.

If the doctor recommends cytisine, the patient stops using all nicotine products, including e-cigarettes and hookah, by day 5 of treatment at the latest, because according to the manufacturer of Desmoxan, taking the medicine together with nicotine can make the side effects of nicotine worse.

Does cannabis with tobacco get in the way of quitting smoking?

In an international online survey of 33,687 cannabis smokers, 77 to 91 percent of respondents from European countries and 4 to 16 percent in North and South America mixed tobacco with it. A joint with tobacco delivers nicotine, so a patient who has given up cigarettes but still smokes cannabis with tobacco is still taking in nicotine. Smoking such a joint during a course of cytisine means taking in nicotine, just like smoking a cigarette.

Patients who also stop smoking cannabis may experience cannabis withdrawal. In a review of 47 studies involving 23,518 people who used cannabis regularly or were dependent on it, 47% experienced withdrawal symptoms. Irritability, anxiety and sleep problems occur after withdrawal from both cannabis and nicotine. When patients stop both substances at the same time, it may be difficult to tell which withdrawal is causing the symptoms.

Studies do not settle whether it is better to stop both substances at the same time or one after the other. In a review of 20 studies, treatment for people using tobacco and cannabis had no clear effect on either quitting tobacco or stopping cannabis. So we agree the order with the patient at the appointment, and the addiction therapist discusses with them the situations in which they reach for a cigarette and for cannabis. For a patient who wants to stop using cannabis, we also offer drug addiction treatment in Lublin.

In the first weeks after quitting, nicotine withdrawal symptoms appear. They include cravings, irritability and anger, anxiety, difficulty concentrating and trouble sleeping. They are strongest in the first week and usually pass after 2 to 4 weeks, and a stop-smoking medicine eases them.

Should you put off quitting until a calmer time?

Before a stressful period at work or at home, a patient may want to put off quitting, because they associate cigarettes with relaxation. The studies included in a review compared people who quit smoking with people who kept smoking. Stress, anxiety and symptoms of depression were later slightly lower in people who had stopped smoking. These were observational data, however, and the authors rated the certainty of most results as low or very low.

In 19 studies, people who were quitting recorded their mood and what was happening around them in real time. Smoking a cigarette after a break was clearly linked to cravings and to cues in the surroundings, for example cigarettes being within reach or someone nearby smoking. No significant link was found between feeling low and smoking a cigarette after a break.

We choose the quit date together with the patient, and in sessions with an addiction therapist we prepare them for situations in which they used to smoke, such as a break at work or meeting friends who smoke. A patient who has an important event coming up, such as an exam, can start treatment a few weeks earlier so that the strongest withdrawal symptoms have passed by then.

What should you do if your mood gets worse after quitting?

Nicotine withdrawal symptoms can include low mood and, rarely, suicidal thoughts or attempts. A patient whose mood clearly worsens while quitting tells the doctor, and suicidal thoughts need immediate medical help, without waiting for the booked appointment.