Nicotine dependence treatment Szczecin

The first step is an appointment with a doctor at the practice at Bohaterów Getta Warszawskiego 16/2 or online. It costs PLN 250 whichever format you choose and does not require a referral, and Nasz Gabinet Szczecin sees patients every day from 8:00 to 20:00. We also treat patients online from the towns of Police, Stargard, Goleniów and Świnoujście who do not want to travel to central Szczecin.

At the appointment, we ask how many cigarettes the patient smokes a day, what conditions they have and what medicines they take regularly. Based on this, the doctor decides whether to recommend a stop-smoking medicine and, if so, which one.

Why do we ask about previous attempts to quit?

Many patients have tried to quit several times, so we ask about each attempt separately. We want to know which medicine the patient took then and at what dose, for how many days, when they smoked their first cigarette after the break and in what situation.

We compare the answers with the recommendations of the manufacturer of the medicine the patient used. A course of NiQuitin Przezroczysty patches usually starts at 21 mg, or at 14 mg for people who smoke no more than 10 cigarettes a day. The manufacturer intends Nicorette Classic Gum 4 mg for people who smoke more than 20 cigarettes a day or who did not stop smoking while using 2 mg gum. With Desmoxan, the patient must stop smoking by day 5 of cytisine treatment at the latest, so anyone who kept smoking throughout the first week was not taking the medicine as recommended.

What do we set out in the treatment plan?

If the doctor recommends a medicine, the patient receives a treatment plan in which we record the medicine, the dose, the date of the last cigarette and what we are doing differently from their previous attempt. If the patient always went back to smoking in the same situation, for example when drinking or after an argument, they discuss with an addiction therapist how to cope with it. Sessions take place online, and each costs PLN 250. For people who are also dependent on alcohol or other substances, we offer addiction therapy in Szczecin.

Quitting smoking rarely works the first time because nicotine changes the way the brain works. It stimulates nicotinic receptors there and increases the release of dopamine, and with daily smoking the brain gets used to its constant presence. 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.

Most people go back to smoking at the very beginning. In a review of studies of smokers who tried to quit without any help, most relapses happened within the first 8 days, and after six months or a year only 3 to 5 percent of them were still not smoking. The urge to smoke also comes back long after withdrawal symptoms have passed, because situations in which the patient smoked for years, such as coffee, a break at work or meeting friends who smoke, trigger a craving on their own.

Ingredients and how they work

Cytisine, recently also called cytisinicline, is the active substance in Desmoxan, Tabex and Recigar. A tablet or capsule contains 1.5 mg of it. It binds to the same receptors in the brain as nicotine but stimulates them more weakly, so it reduces cravings and makes a cigarette smoked during treatment less enjoyable. Varenicline, the active substance in Champix, in 0.5 and 1 mg tablets, works on the same principle.

Nicotine replacement therapy supplies nicotine alone, without the tar and carbon monoxide from smoke. NiQuitin and Nicorette Invisipatch patches release nicotine throughout the day, and it is absorbed through the skin. NiQuitin comes in strengths of 7, 14 and 21 mg per 24 hours, and Nicorette Invisipatch in strengths of 10, 15 and 25 mg per 16 hours. Nicorette Classic Gum, Nicorette Spray and NiQuitin MINI lozenges deliver nicotine through the lining of the mouth whenever the patient feels like smoking. The gum contains 2 or 4 mg of nicotine, one spray 1 mg, and a lozenge 1.5 mg, 2 mg or 4 mg. Bupropion, the active substance in Zyban, is an antidepressant in 150 mg prolonged-release tablets. It blocks the reuptake of noradrenaline and dopamine, which means these substances act for longer in the brain.

Effectiveness in studies

Cochrane, an independent scientific organisation, gathers the results of studies on a given medicine. It checks by what percentage the number of people not smoking after at least six months is higher in the treated group than in a group given placebo or no medicine. In 133 studies involving 64,640 people, nicotine in any form increased the number of non-smokers by 55 percent, patches by 64 percent, gum by 49 percent and lozenges by 52 percent.

In 4 studies involving 4,623 people, cytisine increased the number of non-smokers by 30 percent, and in 41 studies varenicline more than doubled it. In 2 studies that compared the two medicines directly, more people treated with varenicline quit, but the result was too uncertain to decide which medicine works better. In 45 studies, bupropion increased the number of non-smokers by 64 percent, and in head-to-head comparisons it worked about as well as nicotine and less well than varenicline.

Prescription, availability and cost of treatment

The patient can buy nicotine in all its forms and most cytisine products at a pharmacy without a prescription. Champix and Zyban require a prescription, but in September 2026 we did not find Champix in the pharmacies we checked, and the marketing authorisation for Zyban expired in December 2023.

In online pharmacies in September 2026, a pack of cytisine for the whole 25 days cost about PLN 40 to 78, and 24-hour patches for a 10-week course about PLN 606 to 930. 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. None of these medicines is reimbursed by the NFZ, Poland's National Health Fund.

After the last cigarette, nicotine withdrawal symptoms appear, including anger, anxiety, low mood, difficulty concentrating, impatience, insomnia and restlessness. According to a review of research on tobacco withdrawal, they are strongest in the first week and last 2 to 4 weeks. A stop-smoking medicine eases these symptoms, and in online sessions an addiction therapist prepares the patient for the situations in which the urge to smoke is strongest. A patient whose mood clearly worsens tells the doctor, and suicidal thoughts need immediate medical help.

Does physical activity reduce the urge to smoke?

British researchers collected data on every participant in experiments in which smokers either did brief physical exercise or stayed at rest. Participants in these experiments were temporarily not smoking and not taking any medicines. After exercise, including moderate exercise, participants rated their urge to smoke as clearly weaker than people who stayed still. In all the studies included, the urge to smoke was weaker after exercise, and the authors considered these results strong evidence that physical activity reduces cravings in the short term.

So physical activity helps you get through a moment of craving, but it does not replace treatment. A review covered 24 studies involving 7,279 adults. In 21 studies involving 6,607 people, support to quit combined with exercise was compared with support without exercise. No clear increase was found in the proportion of people who quit for at least six months. The authors rate the certainty of this result as low and do not rule out a small benefit.

For a patient whose cravings come at regular times, for example after lunch or after getting home from work, we suggest a brisk walk or climbing the stairs at those times instead of sitting down for a break. A patient with heart disease agrees with the doctor what level of exercise is safe for them.

How can you quit smoking when someone at home still smokes?

American researchers analysed data on 12,067 people followed in the Framingham Study from 1971 to 2003. The chance that a participant was still smoking was 67 percent lower when their spouse had quit, 36 percent lower when a friend had quit, and 25 percent lower when a brother or sister had. This was an observational study, so it shows that people close to each other often quit around the same time, but it does not prove that one person's decision causes the other's.

A summary of 14 studies involving 3,370 people looked at programmes that taught partners, friends or co-workers how to support someone quitting smoking. After six months and after a year, the proportion of non-smokers did not differ clearly from that in groups without the programme, and in most studies that measured support from people close to the participant, the programmes did not increase it.

At the appointment, we ask who smokes at home and where. Together with the patient, we agree what they will ask the people they live with during treatment:

• that no one smokes in the home or in the car the patient uses;
• that cigarettes, lighters and ashtrays are not left where the patient spends the day;
• that a household member who smokes does not offer the patient a cigarette or invite them for a smoke break together.

A partner who also wants to quit books their own appointment. We choose the medicine and dose for each person's health separately, so a couple quitting at the same time do not always take the same medicine.

The Nasz Gabinet app sends a reminder for every dose of cytisine or nicotine set out in the treatment plan, so that the patient takes the medicine without gaps until the end of treatment. The app does not change the medicine, the dose or the times for taking it. The doctor does that at an appointment, which the patient books in the app, including online.

From the quit date, the patient sees in the app the number of days without cigarettes and the money not spent on cigarettes. They can also invite a trusted person to the app, for example a partner who is quitting at the same time. Please contact Nasz Gabinet Szczecin. After we talk, we start the treatment programme in the app and help you buy access to it.

• We do not prescribe sedatives for nicotine withdrawal symptoms. Studies of diazepam, meprobamate, buspirone and beta-blockers, gathered by Cochrane, provided no consistent evidence that they help people quit smoking, and diazepam is a benzodiazepine, which can itself cause dependence.
• We do not offer SSRI antidepressants, such as fluoxetine, paroxetine and sertraline, as stop-smoking medicines. A review of 115 studies of antidepressants found no evidence that SSRIs help people stop smoking. A patient who takes them for depression continues the treatment agreed with their own doctor.

Some changes begin straight away. According to the WHO, after just 20 minutes without a cigarette the heart rate and blood pressure drop, and 5 to 15 years after quitting the risk of stroke falls to that of a non-smoker. According to the WHO, a person who stops smoking at around the age of 30 gains almost 10 years of life.

Quitting smoking also eases the pressure on the household budget. According to a notice from the Minister of Finance, the weighted average retail price of cigarettes in 2025 was about PLN 20.75 a pack. In a home where two people smoke a pack a day each, that comes to about PLN 1,262 a month and more than PLN 15,000 a year.

In Szczecin, no patient quits alone. The doctor looks at why previous attempts failed and chooses a medicine. The addiction therapist helps the patient prepare for the situations in which they used to go back to cigarettes, and the app sends reminders about doses. If the first days are harder than the patient expected, they can book an earlier appointment or session, including online, without travelling from Police or Stargard.