Nicotine dependence treatment Słupsk

Nicotine is the main cause of cigarette addiction, but not the only one. Over the years, a smoker links the effect of nicotine with what they feel with every puff: the taste and smell of the smoke, the scratch in the throat and the movement of the hand to the mouth. After thousands of repetitions, these sensations alone start to reduce the desire for a cigarette and become pleasurable.

This was shown in an American study from 2000 involving 80 smokers. Some of them smoked cigarettes from which almost all the nicotine had been removed. Smoke from these cigarettes clearly reduced nicotine cravings and gave more satisfaction than not smoking at all. Nicotine given intravenously, without smoking, also reduced cravings, but the participants did not feel satisfied afterwards. Only the combination of intravenous nicotine and nicotine-free smoke felt similar to an ordinary cigarette.

Tobacco smoke also changes how the brain works in a way that nicotine alone does not explain. In a 1996 imaging study, smokers had 40 percent less monoamine oxidase B in the brain than non-smokers and former smokers. This enzyme breaks down dopamine, a neurotransmitter involved in motivation and the sense of reward. The authors suggest that lower activity of this enzyme caused by smoke strengthens the effect of nicotine.

That is why a stop-smoking medicine eases nicotine cravings, yet the urge to smoke may come back over coffee, during a break at work or at the sight of someone smoking. The doctor chooses a medicine that reduces nicotine withdrawal symptoms, and the patient prepares for these situations with an addiction therapist.

Smoking is one of the main causes of atherosclerosis of the leg arteries, known as peripheral artery disease. In this condition, narrowed arteries carry too little blood to the legs. A typical symptom is calf pain when walking that goes away after a few minutes of rest. As the disease progresses, wounds that do not heal may appear on the feet, and in the most severe cases amputation may be needed.

In an American study, 39,825 women without heart or blood vessel disease were followed for about 13 years. Women who smoked at least 15 cigarettes a day had an almost 17 times higher risk of symptomatic peripheral artery disease than women who had never smoked. After quitting, the risk dropped markedly. In women who had not smoked for more than 20 years, the risk was 84 percent lower than in women who continued to smoke, although still higher than in women who had never smoked.

Quitting also helps once the disease has developed. In another American study, 204 of 739 patients with symptoms of peripheral artery disease were still smoking at the time of angiography, an imaging test of the arteries using contrast, and 61 of them quit within a year. Within 5 years, 14 percent of the patients who stopped smoking died, compared with 31 percent of those who kept smoking. Over 5 years, 81 percent of those who quit survived without amputation, compared with 60 percent of those who continued to smoke. The study was observational, but the differences remained after taking into account other factors that could have affected the result.

After quitting smoking, the risk of hearing loss decreases. In a Japanese study, the hearing of 50,195 employees aged 20 to 64 was tested every year for up to 8 years. In smokers, high-frequency hearing loss occurred 60 percent more often than in people who had never smoked, and this risk grew with the number of cigarettes smoked per day. In former smokers, the risk was only 20 percent higher and fell even in people who had stopped smoking less than 5 years before the study began. The authors concluded that the extra risk linked to smoking disappears relatively soon after quitting.

Patients quitting in Słupsk do not have to rely only on themselves. If medication causes symptoms or cravings do not ease, they do not need to wait for their scheduled appointment. Earlier appointments are available any day of the week, at ul. Piłsudskiego 2 or by video in the app.

No referral is needed; simply book a medical appointment. Nasz Gabinet in Słupsk is at ul. Marszałka Józefa Piłsudskiego 2 and is open daily from 8:00 to 20:00. Patients choose between a consultation at the clinic and a video consultation in the app. The app allows residents of Ustka, Lębork, Bytów and Miastko to receive consultations without travelling to Słupsk.

At the appointment, the doctor assesses how severe the nicotine dependence is and asks about the patient's medical conditions and the medicines they take regularly. The patient leaves with a treatment plan that names the medicine, its dosage and the day from which they stop smoking. Cytisine and nicotine medicines are available from pharmacies without a prescription. At the next appointment, the doctor checks how the patient is tolerating the medicine and, if needed, changes the dose or the form of the medicine.

Patients purchase one of two treatment options in the app. The Anti-Nicotine Course costs PLN 350 and includes a medical consultation and an e-prescription for the selected medicine. The Anti-Nicotine Treatment Plan costs PLN 2499 and includes the consultation, prescriptions for 3 months and 10 addiction therapy sessions. Patients pay for medication at the pharmacy.

Medication effectiveness is tested in clinical trials comparing a medicine with a placebo, a tablet without an active ingredient, or another medicine. In 2005, British researchers proposed common standards for assessing these studies. Under those standards, success requires at least 6 months of abstinence from the quit date, allowing no more than 5 cigarettes during that period. This rule is solely for counting research outcomes; it is not advice for patients during treatment. Abstinence is confirmed by a test, such as measuring carbon monoxide in exhaled breath. Participants lost to follow-up are counted as smokers.

A Polish trial of cytisine published in 2011 followed these standards. It involved 740 adult smokers. Half of them took cytisine for 25 days and the other half took a placebo, and both groups received only brief advice. In the year after the end of treatment, 8.4 percent of the cytisine group and 2.4 percent of the placebo group stayed off cigarettes continuously. Gastrointestinal complaints were more common among people taking cytisine.

The results of many trials are brought together by Cochrane, an international network of researchers who assess how reliable clinical trials are. Its 2023 review covered 319 trials of stop-smoking medicines. For each medicine, we state how many extra people out of every 100 treated quit smoking compared with placebo or treatment without medication. Cytisine and all nicotine medicines are sold in pharmacies without a prescription.

What is in cytisine tablets?

Desmoxan, Tabex and Recigar contain cytisine, which is now also called cytisinicline. It is a plant alkaloid found in, among other things, laburnum seeds, and its chemical structure is similar to that of nicotine. Cytisine acts on the same receptors in the brain as nicotine, but more weakly. As a result, nicotine cravings ease, and a cigarette smoked during treatment gives less satisfaction.

The course lasts 25 days. For the first 3 days, the patient takes 6 tablets a day, then fewer and fewer, down to 1 or 2 tablets a day in the last days. They smoke their last cigarette no later than day 5 of treatment. In the Cochrane review, cytisine helped 7 more people out of 100 to quit. In September 2026, 100 tablets, enough for the whole course, cost from about PLN 40 to PLN 78. A doctor will not recommend cytisine to a woman who is pregnant or breastfeeding, or to someone who has recently had a heart attack or stroke, or who has unstable angina or clinically significant heart rhythm disorders.

How do NiQuitin and Nicorette Invisipatch patches differ?

Both patches release nicotine through the skin steadily over many hours. NiQuitin Przezroczysty is worn around the clock, and the strongest patch delivers 21 mg of nicotine over 24 hours. Nicorette Invisipatch is worn for 16 hours, from morning to evening, and comes in strengths of 25, 15 or 10 mg per 16 hours. During treatment, the patient moves on to weaker and weaker patches.

A patch keeps nicotine levels fairly steady throughout the day, but after it is applied, the level rises too slowly to control a sudden, strong craving. With a patch alone, there were 2 extra people who managed to quit for every 100 treated. According to September 2026 prices, NiQuitin patches for 10 weeks cost from about PLN 606 to PLN 930 in total.

What helps with a sudden nicotine craving?

When a craving comes on suddenly, nicotine in gum, a mouth spray or lozenges helps. One dose of Nicorette Spray delivers the least nicotine, 1 mg. Nicorette Classic Gum contains 2 or 4 mg, and NiQuitin MINI lozenges 1.5 or 4 mg. Nicotine from these products passes into the blood through the lining of the cheeks and gums, so it starts working sooner than nicotine from a patch. The patient uses them when the urge to smoke comes and does not exceed the daily limit in the leaflet and the treatment plan.

For fast-acting forms of nicotine, the combined result was about 3 extra non-smokers per 100 compared with placebo or no medicine. In the review, a patch combined with gum, spray or lozenges gave a result close to that of cytisine treatment. According to September 2026 prices, a 150-dose spray cost from PLN 62 to PLN 85, less than 105 pieces of 4 mg gum, which cost from PLN 78 to PLN 100.

How effective are varenicline and bupropion?

Varenicline in Champix acts on nicotinic receptors similarly to cytisine, while bupropion in Zyban is an antidepressant. The review found 8 additional quitters per 100 people treated with varenicline and 3 additional quitters with bupropion. Both require prescriptions. Champix was unavailable in the pharmacies we checked in September 2026. Zyban's marketing authorisation expired in December 2023. In practice, doctors in Słupsk therefore choose cytisine or a nicotine medicine.

The treatment plan includes 10 video sessions with an addiction therapist in the app, so residents of Ustka or Lębork do not lose time travelling. In the first sessions, patients explain why they personally want to stop and identify doubts holding them back. The therapist uses approaches such as motivational interviewing. Together, they discuss when patients smoke, who they are with and why they reach for a cigarette, including work breaks with smoking colleagues and cigarettes after lunch.

Subsequent sessions prepare for the quit date, from which the patient stops smoking completely. This follows the medication schedule; with cytisine, it must be no later than day 5. Before then, patients know what they will do when cravings occur or they automatically reach for the pack. They change daily routines, such as their journey to work, learn to manage stress and difficult emotions without cigarettes, and, when needed, discuss lifestyle and concerns about weight gain.

Later sessions help patients maintain new habits, adjust to being non-smokers and agree what to do after a possible lapse to avoid returning to smoking. During this time, the doctor assesses withdrawal symptoms and selects nicotine replacement therapy or cytisine. Medical support is particularly important during quitting, and follow-up dates are arranged individually. Our page on addiction therapy in Słupsk describes sessions in more detail.

After the appointment, we enter the treatment plan into the Nasz Gabinet app: the medicine, its doses and the times to take them. When it is time for a cytisine tablet or a patch change, the app sends a notification. The patient takes one dose a day, chosen at random by the app, in front of the phone camera. They confirm the other doses with a single tap on the screen.

The patient can invite a support person to the programme, for example a partner, a friend or a family member. Up to two people can be invited. They receive the invitation by text message. The invited person creates their own account and accepts the invitation to the programme, and from then on they can see the recordings of doses being taken and receive notifications from the programme. The patient does not have to invite anyone, because the recordings are checked by medical staff in any case.

The app is free to download. Patients pay for a course or treatment plan purchased within it, giving access to the programme. Visit ul. Piłsudskiego 2 or call us. We can help purchase the programme, install the app and invite a support person if the patient wishes.

• We do not order genetic tests whose result is meant to show patients their cancer risk and so persuade them to quit smoking. A review of 20 studies involving 9262 smokers looked at various kinds of information about the health effects of smoking. In the part on genetic tests, giving patients the result was not shown to help them quit. Nor was any benefit shown from giving patients the results of exhaled carbon monoxide measurements.
• We do not recommend clonidine as a stop-smoking medicine. It is a medicine for high blood pressure which, in a review of 6 studies, helped people stop smoking but often caused dry mouth and drowsiness, and the higher the dose, the stronger these effects were. The review authors concluded that these side effects limit the usefulness of clonidine, and the studies assessed were few and may have been biased.