Nicotine dependence treatment Opole

Treatment usually lasts from a few weeks to a few months, and its length depends on the medicine. A course of cytisine takes 25 days, nicotine patches about 10 weeks, nicotine gum at least 3 months, and the treatment programme in the Nasz Gabinet app 3 months. For the first appointment, the patient comes to Nasz Gabinet Opole at Torowa 16 or connects with the doctor by video call, on any day from 8:00 to 20:00. No referral is needed, and the appointment costs PLN 250.

At the first appointment, the doctor chooses a medicine to treat nicotine dependence. The doctor finds out how many years and how heavily the patient has smoked, whether they wake up at night to smoke, and what conditions they are being treated for and what medicines they take. The doctor then recommends cytisine or a nicotine medicine and, together with the patient, sets the day of the last cigarette. With cytisine, this is no later than day 5 of treatment, and with a patch, it is the day the first patch is applied.

Over the following weeks, the patient takes the medicine according to plan and, with an addiction therapist, prepares for moments when the urge to smoke comes back. Each online session costs PLN 250. We schedule a follow-up appointment towards the end of treatment, before the patient is left without medication. What the sessions involve is explained in our description of addiction therapy in Opole.

It leads to dependence more often than alcohol. A large American study found that among people who have ever used nicotine, dependence develops roughly three times as often as among people who drink alcohol. In this respect, nicotine also came ahead of cannabis and cocaine.

The researchers analysed interviews with adults living in the United States, carried out in two waves several years apart. The participants included 15,918 people who had used nicotine in their lifetime, 28,907 people who drank alcohol, 7389 people who had used cannabis and 2259 people who had used cocaine. According to the calculations, dependence developed over a lifetime in 67.5 percent of people who used nicotine, or about two in three. Among those who drank alcohol, the figure was 22.7 percent, among cocaine users 20.9 percent and among cannabis users 8.9 percent.

At the same time, nicotine dependence developed slowly. Half of the people who became dependent on it met the criteria for dependence within about 27 years of first use. For alcohol, this period was about 13 years, for cannabis 5 and for cocaine 4 years.

The study shows how often dependence develops, but it does not compare the harm to health. It does show, however, that dependence develops in most people who have ever used nicotine, so difficulty giving up cigarettes is not unusual, including for someone who has stopped drinking. At Nasz Gabinet Opole, we treat both types of dependence, and we write about treating alcohol dependence on the page about alcohol addiction treatment in Opole.

Partly. Some people who stopped smoking with the help of a medicine go back to cigarettes months or years later, but in studies of nicotine medicines lasting several years, the benefit of treatment persisted after it ended. The effectiveness figures come from a review of 319 studies published in 2023 by Cochrane, an independent scientific organisation whose authors combine the results of many clinical trials into one analysis and assess how reliable they are. The medicine prices below are from September 2026.

In the Cochrane review, the effectiveness of medicines was assessed on the basis of not smoking after at least six months. The differences given come from comparing treatment with placebo or no medicine.

How does cytisine work and what is known about the effectiveness of treatment?

Desmoxan, Tabex and Recigar tablets each contain 1.5 mg of cytisine, a plant alkaloid whose molecule resembles nicotine. Cytisine occupies the sites in the brain that nicotine acts on, but produces a weaker signal there. As a result, nicotine cravings are weaker, and if the patient smokes despite treatment, the cigarette gives them less pleasure than usual. For the first 3 days, the patient takes no more than 6 tablets a day, then fewer and fewer, and finishes the course after 25 days. They stop smoking no later than day 5. In studies, cytisine increased the number of people who managed to quit by about 7 for every 100 treated. One pack of 100 tablets is enough for the whole course. In September 2026, it cost from PLN 40 to PLN 78.

What the situation looks like a year later is shown by a study from a smoking cessation clinic at a cancer centre in Warsaw. The study included 436 consecutive clinic patients who were recommended cytisine with only brief support. A total of 13.8 percent of all those included did not smoke at all for 12 months, and at the last visit this was confirmed by measuring carbon monoxide in exhaled breath. The study had no comparison group, but according to the authors, this result is similar to that of nicotine treatment. Of the 315 people who took the medicine, 49 stopped it because of side effects, mainly stomach complaints and nausea.

Do patients go back to smoking after nicotine treatment?

Some do, but the advantage of treatment remains. In a pooled analysis of 12 placebo-controlled studies, people treated with nicotine were followed for 2 to 8 years. A total of 4792 people took part. Roughly 30 percent of those who were not smoking after a year later went back to smoking, and this happened about as often after nicotine as after placebo. Most of these relapses occurred 1 or 2 years after the first year. The advantage of nicotine treatment therefore fell from about 11 extra non-smokers per 100 after a year to about 7 per 100 after an average of 4.3 years, but it did not disappear.

The NiQuitin Przezroczysty patch releases nicotine through the skin around the clock, and Nicorette Invisipatch for 16 hours, because it is removed before going to bed. One patch is applied a day, and every few weeks the patient moves on to a weaker one. With a patch alone, about 2 more people per 100 treated quit smoking than without medication. A set of NiQuitin patches for 10 weeks costs from PLN 606 to PLN 930.

Nicorette Classic Gum, Nicorette Spray mouth spray and NiQuitin MINI lozenges are used when a sudden urge to smoke comes, because nicotine is absorbed from them through the lining of the mouth faster than from a patch. The daily limit is 15 pieces of gum or 15 lozenges. The spray is used no more than 2 times at once, 4 times an hour and 64 times a day. For fast-acting forms of nicotine, the combined result was about 3 extra non-smokers per 100 compared with placebo or no medicine. Combining one of these forms of nicotine with a patch gave a result close to that of cytisine treatment. A 150-dose spray cost PLN 62 to PLN 85, and 105 pieces of 4 mg gum cost PLN 78 to PLN 100.

Does a longer course reduce the risk of going back to smoking?

Studies of varenicline suggest so. Varenicline, the active substance in Champix, works in a similar way to cytisine and helped about 8 more people per 100 to quit, while bupropion, the antidepressant in Zyban, helped about 3 more. In a study conducted in 7 countries, 1927 smokers took varenicline for 12 weeks. Of those who stopped smoking during that time, 1210 people were randomly assigned to varenicline or placebo for another 12 weeks. From week 13 to week 52, 43.6 percent of the varenicline group and 36.9 percent of the placebo group did not smoke at all.

In 2019, the same organisation pooled 81 studies on preventing relapse to smoking. Taking varenicline for longer reduced the number of relapses. No clear benefit was shown for taking bupropion for longer, and in people who had quit with help, none was shown for longer use of nicotine either, although the certainty of these results was low.

Varenicline and bupropion are available only on prescription. Zyban lost its marketing authorisation in December 2023, and none of the pharmacies we checked had Champix in September 2026. In practice, therefore, the choice in Opole comes down to cytisine and nicotine medicines. At the follow-up appointment, the doctor discusses with the patient a plan for the weeks after the last dose, and if the patient goes back to smoking, the doctor can plan another course of treatment.

Yes, and in people who already have the disease, smoking may also weaken the effect of medicines. Rheumatoid arthritis is a chronic disease in which the immune system attacks the body's own joints, most often in the hands and feet. The joints hurt, swell and stiffen, especially in the morning.

A pooled analysis of 10 studies included a total of 4552 cases of the disease. The researchers measured the amount of tobacco smoked in pack-years, where one pack-year means a pack of cigarettes a day for one year. Even at 1 to 10 pack-years, the risk of developing the disease was 26 percent higher than in people who had never smoked, and at 21 to 30 pack-years it was roughly twice as high. Above 20 pack-years, it did not rise much further. The risk rose more for the form of the disease in which rheumatoid factor is detected in the blood.

The American Nurses' Health Study followed 230,732 women over many years, of whom 1528 developed the disease. In smokers, the risk was 47 percent higher than in women who had never smoked. As the years since quitting went by, there were fewer and fewer cases. Women who had quit at least 30 years earlier developed the form with antibodies typical of the disease in the blood 37 percent less often than women who had quit within the last 5 years. However, they still developed it slightly more often than women who had never smoked.

In a Swedish study of patients with early disease, after 3 months of treatment with methotrexate, a good response was found in 27 percent of smokers and 36 percent of people who had never smoked. With biological medicines that block tumour necrosis factor, 29 percent of smokers and 43 percent of people who had never smoked achieved a good response. In former smokers, the chance of a good response was not lower. That is why the doctor advises a person with this disease to quit smoking as early as possible and, before choosing a stop-smoking medicine, checks what the patient is already taking.

The Nasz Gabinet app sends a reminder for every dose in the treatment plan, for example the next cytisine tablet or a patch change. The patient ticks off a dose with a single tap. Every day, the app randomly chooses one dose, which the patient records themselves taking on their phone. The short recording goes to medical staff. The patient reaches for gum, spray or a lozenge when they suddenly want to smoke, so these medicines are not filmed.

Questions between appointments are answered by the assistant in the app, which is an artificial intelligence program, not a doctor or a therapist. You can ask it at any time, for example what to do about the urge to smoke over morning coffee. The assistant remembers from earlier conversations the reasons the patient gave for quitting and the situations in which it is hardest for them not to smoke, so the patient does not have to explain everything again. The assistant does not change the medicine dose, because treatment decisions are made by the doctor.

Downloading the app costs nothing. Only the treatment programme that we run in it is paid for. We start the programme during an appointment at Torowa 16 in Opole or after a phone call, and link it to the plan the patient agreed with the doctor.

• We do not use bioresonance. The method assumes that a device reads and changes the body's electromagnetic vibrations. As evidence of its effectiveness for quitting smoking, a single pilot study from Turkey involving 190 smokers is cited, published in 2014 in a journal devoted to complementary medicine. In the PubMed database, which collects medical publications, we found no later study confirming this result. Cytisine and nicotine medicines have been tested in many clinical trials.
• We do not recommend buying varenicline or bupropion online. They are prescription medicines, and pharmacies in Poland may only deliver non-prescription medicines to people's homes. A shop that sends them without a prescription operates outside the law, so there is no way of knowing where the tablets come from. In July 2021, contamination with N-nitroso-varenicline above the permitted limit was found in batches of Champix, and Poland's Chief Pharmaceutical Inspectorate issued a notice suspending distribution of the medicine and recalling several batches. Bupropion is not used, among others, in people who have ever had a seizure, which is why a doctor decides on such a medicine after examining the patient.

Quitting smoking reduces the risk of pancreatic cancer, a cancer that causes no symptoms for a long time. The risk starts to fall within a few years without cigarettes.

Italian researchers pooled 78 studies on smoking and pancreatic cancer. In smokers, the risk of developing the disease was on average 1.8 times higher than in people who had never smoked, and in former smokers 1.2 times higher. The risk rose sharply even with a few cigarettes a day and after a few years of smoking. After quitting, it fell quickly, and after 20 years without cigarettes it was 40 percent lower than in people who continued to smoke. Only after almost 20 years was it close to the risk in people who had never smoked.

A patient who starts treatment at Nasz Gabinet Opole receives support from the whole team in quitting smoking. If side effects appear or the urge to smoke is still strong, the doctor adjusts the treatment. With an addiction therapist, the patient works out how to cope in situations in which they used to light up. Medical staff can see in the app which doses the patient has taken. An appointment at our practice at Torowa 16 or a video call can be booked for any day of the week between 8:00 and 20:00.