Nicotine dependence treatment Poznań

In Poznań, we see patients at Nasz Gabinet at Górki 17A every day from 8:00 to 20:00, and the first appointment can also take place online. It costs PLN 250 and does not require a referral. We also treat patients from Gniezno, Piła, Leszno and Konin online. At the end of the appointment, the doctor decides whether to recommend a medicine and when the patient should start treatment. Further treatment includes sessions with an addiction therapist and taking the recommended medicine.

Do you have to be determined to quit before coming to an appointment?

No. The patient does not have to come with a date set for their last cigarette. Someone whose family, or the doctor treating their high blood pressure or asthma, is urging them to quit can also come, even if they are not yet sure they want to try. We then talk about how much and in what situations the patient smokes, how their previous attempts went and what worries them most, for example cravings at work or putting on weight.

Does talking to a doctor help people quit smoking?

A review by Cochrane, an independent scientific organisation that brings together the results of studies on one topic, covered 42 studies involving more than 31,000 smokers. In 17 studies, brief advice from a doctor was compared with no advice. More people quit after advice than without it. The authors assumed that without any help 2 to 3 percent of smokers quit, and that brief advice from a doctor raises this figure by a further 1 to 3 percentage points. In direct comparisons, longer and more intensive advice gave a small additional benefit.

Why do we not recommend medicine just in case?

We do not recommend medicine just in case. The manufacturer of Desmoxan intends cytisine for people who seriously intend to stop smoking, so the doctor considers it once the patient has made that decision. A patient who needs time after the first conversation can book another appointment later or start with sessions with an addiction therapist. Sessions take place online, and each costs PLN 250. For people who are also dependent on alcohol or medicines, we offer addiction therapy in Poznań.

In the United States, 70 percent of smokers want to quit, and every year 40 percent stop smoking for at least one day. Of those who try to quit on their own, 80 percent go back to cigarettes within a month, and only 3 percent of smokers quit for good each year. These figures come from a US review of research on nicotine dependence.

The reason is the way nicotine acts on the brain. Nicotine stimulates nicotinic receptors there and increases the release of dopamine. With daily smoking, the brain adapts to it, so after giving up cigarettes irritability, low mood, restlessness and anxiety appear, and some people also feel that nothing gives them pleasure. According to the same review, these mood disturbances are about as severe as those seen in people treated in outpatient clinics for mental disorders. The anxiety and stress caused by nicotine withdrawal strongly push people to smoke again, and the next cigarette relieves them for a while.

The World Health Organization classifies nicotine dependence, also called nicotine addiction, as a disease and describes it in ICD-10 under code F17.2 and in ICD-11 under code 6C4A.2. Tobacco-related diseases are caused mainly by other components of smoke, but it is nicotine dependence that makes a smoker inhale them for years. That is why we treat it like other forms of dependence, with sessions with an addiction therapist and, if the doctor recommends one, a medicine. A patient whose mood clearly worsens after quitting tells the doctor, and suicidal thoughts need immediate medical help.

The doctor chooses from cytisine, nicotine replacement therapy, varenicline and bupropion. For each medicine, we give how it works, by how much it increased the number of non-smokers in studies and how much it cost in online pharmacies in September 2026.

Cytisine in 1.5 mg tablets

Cytisine is the active substance in Desmoxan, Tabex and Recigar. Its structure resembles nicotine and it binds to the same receptors in the brain, but stimulates them more weakly, so it reduces cravings and the pleasure of a cigarette. In 4 studies involving 4,623 people, 30 percent more people taking cytisine than people in the placebo group 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 25-day course cost about PLN 40 to 78.

Nicotine patches for 16 or 24 hours

NiQuitin Przezroczysty is worn around the clock, in strengths of 21, 14 and 7 mg, and Nicorette Invisipatch for 16 hours, in strengths of 25, 15 and 10 mg. Nicotine passes through the skin without the tar and carbon monoxide from smoke, and its blood level stays steady, without the sharp rise that follows a puff on a cigarette. With the NiQuitin 21 mg patch, this level averages about 17 ng/ml, compared with an average of about 44 ng/ml after half an hour of smoking cigarettes. 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 24-hour patches cost about PLN 606 to 930 in September 2026.

Nicotine gum, spray and lozenges

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 when the patient feels like smoking. After starting to chew the gum, nicotine can be detected in the blood within 5 to 7 minutes. 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. In September 2026, 105 pieces of 4 mg gum cost PLN 78 to 100, and a spray with 150 doses PLN 62 to 85.

Prescription-only varenicline and bupropion

Varenicline, the active substance in Champix, in 0.5 and 1 mg tablets, binds to nicotinic receptors in a similar way to cytisine. In 41 studies, it 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, the active substance in Zyban, in 150 mg tablets, is an antidepressant that contains no nicotine. In 45 studies, 64 percent more people were not smoking after treatment than in placebo or no-treatment groups. The medicine requires a prescription, and the marketing authorisation for Zyban expired in December 2023.

The patient then books an earlier appointment or session, so that the plan for difficult situations can be improved straight away, without waiting for the end of treatment. Studies show that smoking in the first 2 weeks after quitting is linked to a worse result after six months.

Two US studies, involving 88 and 112 people quitting with a nicotine patch, looked at whether smoking in the first 2 weeks predicts the result after six months. Among patch users who smoked even once in week 2 after quitting, 83 percent in the first study and 97 percent in the second were smoking after 6 months. Among those who did not smoke at all in week 2, 46 and 41 percent were still not smoking after 6 months. Of the patch users who were smoking after six months, 74 percent had started smoking again in week 1 or 2.

The number of cigarettes smoked before treatment, the Fagerström test score and the carbon monoxide level in exhaled breath did not give consistent predictions of the treatment result. The results describe groups of people and do not determine how treatment will turn out for an individual patient.

Should you stop cytisine after smoking a cigarette?

In a patient taking cytisine who smokes a cigarette, the side effects of nicotine may get worse. If the result of treatment is unsatisfactory, the manufacturer of Desmoxan recommends stopping it, and another course can be started after 2 to 3 months. Whether one or a few cigarettes mean an unsatisfactory result is for the doctor to decide, so the patient does not stop the medicine on their own but books an appointment, including online.

How does an addiction therapist help after a cigarette?

In a session with an addiction therapist, the patient goes back over the situation in which they smoked: where they were, who they were with, what they felt and what led up to the cigarette. They then plan how to act in a similar situation next time. Before the session, the therapist can see the craving records the patient keeps in the Nasz Gabinet app.

The same condition may rule out one medicine and call only for caution with another. Unstable angina is a contraindication to cytisine, while with a nicotine patch the manufacturer advises caution in this situation. Current or past seizures rule out bupropion, with varenicline the manufacturer advises caution, and with nicotine replacement therapy the doctor weighs up benefits and risks. The patient therefore brings a list of their conditions and all their medicines to the appointment, and the doctor chooses the medicine and dose.

In which conditions is cytisine not used?

According to the manufacturer of Desmoxan, cytisine is not used in unstable angina, after a recent heart attack or stroke, in clinically significant heart rhythm disorders, during pregnancy or while breastfeeding. Caution is needed in ischaemic heart disease and heart failure, high blood pressure, atherosclerosis and other peripheral vascular diseases, peptic ulcer disease, gastro-oesophageal reflux disease, an overactive thyroid, diabetes and schizophrenia. The medicine is also not recommended for people with impaired liver or kidney function, people under 18 or people over 65.

When does nicotine replacement therapy call for caution?

The manufacturer of NiQuitin patches advises caution in conditions including uncontrolled high blood pressure, heart failure, severe heart rhythm disorders, after a recent heart attack or stroke, severe peripheral vascular disease, atopic dermatitis, moderate or severe liver or kidney failure, an active stomach ulcer and an overactive thyroid. A person with diabetes monitors their blood sugar during treatment. In a person with heart disease, combining a patch with gum or spray needs to be assessed by medical staff.

Any form of nicotine replacement therapy, including patches, can make symptoms worse in people with active inflammation of the oesophagus, mouth or throat, gastritis or peptic ulcer disease. A patient with such symptoms mentions them before the doctor chooses a medicine.

Varenicline and kidney disease

In mild and moderate kidney impairment, the dose does not change. For a patient with moderate impairment who tolerates side effects poorly, the doctor may reduce the dose to 1 mg a day. In severe impairment, the patient takes 0.5 mg once a day for the first 3 days and then 1 mg once a day. According to the manufacturer, the medicine should not be used in people with end-stage kidney failure, and it is used with caution in people with a history of seizures.

Bupropion, epilepsy and eating disorders

Contraindications include current or past seizures, a tumour of the central nervous system, current or past bulimia or anorexia nervosa, severe liver cirrhosis, a history of bipolar disorder, concurrent treatment with MAO inhibitors, and abruptly stopping alcohol or benzodiazepine sedatives.

The parent of a small child is treated in the same way as other patients: they take a medicine and have sessions with an addiction therapist. There are, however, some extra things we ask about at the appointment: where people smoke at home, whether the mother is breastfeeding and where the nicotine medicines will be kept.

In an analysis of 60 studies, babies and young children living in a home where someone smoked had a 54 percent higher chance of lower respiratory tract infections and a more than two and a half times higher chance of bronchiolitis. Children living with a smoker had a 62 percent higher chance of middle ear disease. According to a review of studies that followed children over a longer period, passive smoking increases wheezing and asthma in children and teenagers by at least 20 percent.

Does smoking on the balcony protect a child from smoke?

Some parents smoke only on the balcony or outside the house so that the child does not breathe in smoke. In a Swedish questionnaire study of 1,990 children aged 12 to 24 months, one in five children had at least one parent who smoked. For 7 percent of the children, their parents smoked indoors, and for 13 percent only outdoors. A cough lasting more than 2 weeks after an upper respiratory tract infection and wheezing without infection were statistically significantly more common in children whose parents smoked indoors than in children of non-smoking parents. The authors concluded that the widespread belief that smoking outdoors is enough to protect a child from smoke needs further research. The study was based on a postal questionnaire, so it does not show the causes of these differences.

Which stop-smoking medicines can be used while breastfeeding?

Cytisine is not taken while breastfeeding, because the manufacturer of Desmoxan lists it among the contraindications. Nicotine from cigarettes and from nicotine replacement therapy passes into breast milk. According to the manufacturer of NiQuitin patches, however, the baby is exposed to a relatively small amount of nicotine from replacement therapy. This exposure is less dangerous than passive smoking. It is best for a breastfeeding mother to quit without medication, and if she cannot, medical staff may recommend replacement therapy. Gum, a lozenge or the spray should then be used just after a feed, so that as much time as possible passes before the next one. The manufacturer does not recommend combining a patch with oral forms while breastfeeding because there are no studies, unless medical staff consider it necessary.

How can you protect a child from nicotine poisoning from patches and gum?

A dose of nicotine that an adult smoker tolerates well can cause severe or even fatal poisoning in a small child. Patches, gum, lozenges and spray should be kept out of children's reach. A removed patch is folded in half, sticky side in, put into the opened sachet or wrapped in a piece of aluminium foil, and only then thrown away. If you suspect that a child has swallowed nicotine gum or a lozenge, sucked on a patch or stuck one on themselves, get urgent medical help.

Online appointments and therapy sessions for parents of small children

The parent of a small child can have the first appointment online. In sessions with an addiction therapist, they plan what to do at the times they used to go out for a cigarette, for example during the child's nap or in the evening when the child is already asleep.

Above all, the Nasz Gabinet app helps the patient not to miss any doses. It sends a reminder for every dose in the treatment plan, so with cytisine the patient gets 6 reminders a day, every 2 hours, in the first 3 days of treatment. From the quit date, the app also counts the days without cigarettes and the złoty the patient has not spent on cigarettes.

If the patient has side effects, for example sleep problems, the doctor decides on any change of medicine or dose at an appointment, including online. We activate the treatment programme in the app for patients who contact Nasz Gabinet Poznań, so please get in touch. We will then help you buy access to the programme and go through the installation.

• We do not treat with hypnosis. A review of 14 studies involving 1,926 people provided no reliable evidence that hypnosis helps people quit smoking more effectively than other methods or no treatment, and 10 of these studies were judged to be at high risk of bias.
• We do not recommend St John's wort or SSRI antidepressants as stop-smoking medicines. In a review of 115 studies of antidepressants, effectiveness was confirmed for bupropion, but no evidence was found that St John's wort or SSRIs help people stop smoking. A patient who takes an SSRI for depression does not stop it when quitting smoking unless the doctor treating them decides so.

Quitting smoking extends life even for people who have smoked for many years. According to the WHO, a person who stops smoking at around the age of 50 gains about 6 years of life, and at around the age of 60 about 3 years. After 10 years without cigarettes, the risk of cancer of the mouth, throat, oesophagus, bladder, cervix and pancreas also falls.

Other members of the household also gain from quitting. A parent who stops smoking protects their child from tobacco smoke, which increases the risk of lower respiratory tract infections and middle ear disease.

At Nasz Gabinet Poznań, no patient is left to quit alone, even if they are still wondering whether to try. The doctor chooses a medicine to suit their conditions and the medicines they take, the addiction therapist helps them plan how to cope in difficult moments, and the app sends reminders about doses. After smoking a cigarette or if side effects appear, the patient books an earlier appointment, at the practice at Górki 17A or online.