Nicotine dependence treatment Olsztyn

In some people, the first symptoms of nicotine dependence can appear after just a few weeks of occasional smoking, before they start smoking every day. These symptoms include, for example, a strong urge to smoke, irritability and difficulty concentrating when smoking is not possible, as well as a failed attempt to quit.

An American study followed 679 pupils aged 12 and 13 for 30 months. Of the 332 pupils who used tobacco during that time, 40 percent reported at least one symptom of dependence. Half of the girls with such symptoms noticed them no later than 21 days after they started smoking at least once a month. For boys, this period was 183 days. When the first symptom appeared, participants usually smoked 2 cigarettes on one day a week. Pupils who had even one symptom were much more likely to still be smoking at the end of the study.

Another American study involved 367 teenagers who smoked. Signs of losing control over smoking, such as a failed attempt to quit or a feeling that cigarettes were indispensable, were reported by 9 percent of those who had smoked 2 cigarettes in their lifetime and by 44 percent of those who had smoked 5 to 9 cigarettes. Among those who had smoked at least 100 cigarettes in their lifetime, the figure reached 96 percent.

These results show that dependence is not determined only by the number of cigarettes smoked. That is why, at the appointment, the doctor also asks about nicotine cravings, how the patient feels on days without cigarettes and how previous attempts to quit went. The medicine eases nicotine withdrawal symptoms, and in sessions with an addiction therapist the patient learns to ride out the urge to smoke.

Smoking increases the risk of dementia. In this disease, memory, thinking and orientation deteriorate so much that a person can no longer manage everyday life on their own. The most common forms of dementia are Alzheimer's disease and vascular dementia, caused by damage to the blood vessels of the brain.

In an analysis of 37 studies that followed people without dementia at the start, smokers had a 30 percent higher risk of dementia than people who had never smoked. The risk of Alzheimer's disease was 40 percent higher, and of vascular dementia 38 percent higher. Every 20 cigarettes smoked a day increased the risk of dementia by a further 34 percent. In former smokers, the authors found no increased risk of any of these forms of dementia.

The link is also seen in older people. A study from South Korea followed 46,140 men aged 60 or over for 8 years. Men who had not smoked for at least 4 years had a 14 percent lower risk of dementia than men who smoked throughout, and their risk of vascular dementia was 32 percent lower. Both studies were observational. They therefore show a link between smoking and dementia, but do not prove that smoking caused the disease.

Smoking increases the risk of community-acquired pneumonia, that is, pneumonia that starts outside hospital. In a review of 27 studies involving 460,592 people, smokers developed it roughly twice as often as people who had never smoked, and the risk grew with the number of cigarettes smoked. In former smokers, the risk was also higher than in people who had never smoked, but less so than in smokers.

Smoking also makes serious pneumococcal infections more likely. Pneumococci are bacteria that commonly cause pneumonia. An American study included adults aged 18 to 64 without immune disorders. Among patients in whom pneumococci had spread to the blood or other organs, 58 percent smoked, compared with 24 percent in the healthy comparison group. The risk was higher the more a person smoked, and lower the more time had passed since they quit.

At Nasz Gabinet in Olsztyn, patients have someone to ask about medication and difficult smoke-free moments throughout treatment. The doctor chooses medication and changes the dose when needed. Patients who choose the Anti-Nicotine Treatment Plan work with a therapist on managing the first smoke-free weeks. The app provides medication reminders. If cravings do not ease or medication causes symptoms, patients do not have to wait for the scheduled follow-up. They can arrange an earlier appointment at ul. Kopernika 44 or by video in the app, including at weekends.

You do not need a referral for nicotine dependence treatment in Olsztyn. Nasz Gabinet Olsztyn at Kopernika 44 is open seven days a week, from 8:00 to 20:00. Treatment consists of several stages.

1. Patients choose and purchase a treatment option in the Nasz Gabinet app. The Anti-Nicotine Course costs PLN 350 and includes a medical consultation with an e-prescription. The Anti-Nicotine Treatment Plan costs PLN 2499 and includes a consultation, prescriptions for 3 months of medication and 10 addiction therapy sessions. The medical consultation takes place at the clinic or by video in the app.
2. The doctor asks how many years and how many cigarettes a day the patient has smoked, how previous quit attempts ended, and about illnesses and current medicines. This helps assess the degree of dependence.
3. Patients receive instructions specifying the medicine, doses and date of the last cigarette. The doctor names the particular product and explains whether it requires a prescription. Nicotine medicines and most cytisine preparations are available without one.
4. Patients with the treatment plan meet an addiction therapist by video in the app.
5. At follow-up, the doctor checks whether cravings are easing and how well the medicine is tolerated. If cravings persist or medication causes symptoms, the doctor adjusts the dose or suggests another formulation.

Video consultations mean residents of Ostróda, Szczytno, Dobre Miasto, Barczewo and Lidzbark Warmiński do not need to travel to the clinic. Our page on addiction therapy in Olsztyn describes help with other addictions.

In 2024, the World Health Organization published its first guideline on treating tobacco dependence in adults. It recommends combining medication with support for behaviour change. This is a strong recommendation based on high-certainty evidence. Such support includes one-to-one sessions with a therapist, group sessions or telephone counselling. According to the guideline, text messages and phone apps can be offered to people who are quitting smoking, but this recommendation is weaker because the evidence of their effectiveness is less certain.

The medicines below were assessed by whether participants were not smoking after at least six months. The differences shown compare treatment with placebo or no medicine.

The guidelines list varenicline, nicotine, bupropion and cytisine. The first three are described as first-line medicines. Cytisine is discussed separately because the certainty of evidence for its effectiveness was rated moderate and it is licensed in fewer countries. Most cytisine preparations in Polish pharmacies are available without a prescription. Below, we compare stop-smoking medicines using effectiveness data from the 2023 Cochrane review. Cochrane brings together researchers from many countries, and its reviews combine results from similar clinical studies into one assessment. Prices come from pharmacies we checked in September 2026.

• Cytisine in Desmoxan, Tabex and Recigar tablets. It is a plant alkaloid with a structure similar to nicotine. It partly stimulates nicotine receptors in the brain, so the urge to smoke decreases, and a cigarette lit during treatment no longer brings the relief the smoker is used to. The tablets are taken for 25 days in decreasing numbers, and smoking must stop by day 5. Among 100 people treated with cytisine, 7 more quit smoking than among 100 people in comparison groups who received a placebo or no medicine. The whole course fits in one pack of 100 tablets, which cost from about PLN 40 to PLN 78.
• Nicotine patch, for example NiQuitin Przezroczysty, worn around the clock, or Nicorette Invisipatch, worn for 16 hours during the day. Nicotine passes through the skin slowly and evenly, so a patch eases cravings throughout the day but acts too slowly for a sudden, strong urge to smoke. Treatment with NiQuitin patches usually lasts 10 weeks, and their strength decreases from 21 mg through 14 mg to 7 mg per 24 hours. With a patch alone, the advantage was 2 people per 100 treated. NiQuitin patches for the whole course cost from about PLN 606 to PLN 930.
• Fast-acting nicotine: Nicorette Spray with 1 mg of nicotine per dose, Nicorette Classic Gum 2 or 4 mg and NiQuitin MINI lozenges 1.5 or 4 mg. Nicotine is absorbed through the lining of the mouth, so the patient uses these medicines when the urge to smoke comes. They do not exceed 4 sprays per hour and 64 per day, or 15 pieces of gum or lozenges per day. For fast-acting forms of nicotine, the combined result was about 3 extra non-smokers per 100 compared with placebo or no medicine. Combined with a patch, fast-acting nicotine gave a result close to that of cytisine treatment. A 150-dose spray cost from PLN 62 to PLN 85, and 105 pieces of 4 mg gum from PLN 78 to PLN 100.
• Varenicline and bupropion, the active substances in Champix and Zyban. Varenicline acts in the brain in a similar way to cytisine, while bupropion is an antidepressant. The advantage was 8 people per 100 treated with varenicline and 3 with bupropion. Both medicines require a prescription. Zyban's status does not mean that all bupropion products are unavailable; other medicines containing this substance are indicated for treating depression. Zyban lost its marketing authorisation in December 2023, and Champix was not available in the pharmacies we checked in September 2026.

In Olsztyn, the doctor therefore usually chooses cytisine or nicotine. If a patch alone does not control sudden cravings, gum, spray or lozenges may be added. In line with WHO recommendations, the treatment plan combines each of these medicines with addiction therapy sessions.

The World Health Organization guidelines discussed below recommend combining medication with support for behaviour change. At Nasz Gabinet in Olsztyn, this support takes the form of addiction therapy sessions in the app. The Anti-Nicotine Treatment Plan for PLN 2499 includes 10 video sessions. The Anti-Nicotine Course for PLN 350 includes a medical consultation with an e-prescription. With either option, patients buy medication separately at a pharmacy.

At the start of therapy, patients explore why they smoke and why they want to stop. The therapist helps identify moments when they reach for a cigarette and write down their own reasons for quitting. One approach is motivational interviewing: questions help patients examine their doubts and identify why they want to stop. Before the quit date, the first day without any cigarettes, they prepare a plan for that day and for strong cravings. The date is aligned with the medicine; with cytisine, it must be no later than day 5.

After patients stop smoking, conversations address everyday life: new routines to replace cigarette breaks, ways of managing stress and emotions, lifestyle changes and worries about weight gain. Later sessions help patients maintain these changes, feel like non-smokers and prepare for a lapse so that one cigarette does not undo the whole course of therapy. During this period, the doctor reviews withdrawal symptoms and decides on nicotine replacement therapy or cytisine. Medical support is particularly important during the quitting weeks; follow-up dates are agreed with the patient.

We enter the medicine, doses and times from the treatment plan into the Nasz Gabinet app. The app sends a reminder for every cytisine tablet and every patch change. Once a day, it randomly picks one dose, which the patient takes in front of the phone camera, and the patient marks the other doses as taken with a single tap on the screen. The recordings are reviewed by medical staff.

Consecutive days on which the patient has taken all doses make up a streak. When the patient has taken all doses for the required number of consecutive days, the practice extends their access to the programme. The app shows how many days are left until the next reward. The extra days are granted as soon as the last required dose is confirmed. A missed dose resets the streak, but days already added to the programme are kept.

The app is free to download. Patients purchase a course or treatment plan within it; both give access to the programme run by the clinic. To get started, visit ul. Kopernika 44 or call us. We can help install the app and activate the programme.

• We do not recommend silver acetate gum, lozenges or sprays. Combined with smoke, silver acetate leaves an unpleasant taste in the mouth that is meant to put people off smoking. The review authors found only 2 studies that checked whether participants were still smoking after at least 6 months. In these studies, silver acetate did not increase the number of non-smokers compared with placebo. The authors suggest that smokers simply stopped using a product that was designed to be unpleasant.
• We do not recommend oils, drops or inhalers containing cannabidiol, known as CBD. In a pilot placebo-controlled study, 24 smokers used an inhaler with CBD or placebo for a week whenever they felt like smoking. People using the CBD inhaler smoked about 40 percent fewer cigarettes that week, but the study was very small and did not check whether anyone quit smoking for longer. CBD oils sold in shops are not stop-smoking medicines.