Nicotine dependence treatment Wałbrzych

A cigarette brings relief straight away, while the benefits of not smoking show up after months and years. In studies, smokers valued rewards they had to wait for less than other participants did. Researchers call this delay discounting.

At the University of Vermont, researchers compared 23 smokers, 22 people who had never smoked and 21 former smokers. Participants stated whether they preferred a smaller sum immediately or a larger sum later. Smokers were more inclined than the other groups to choose the smaller, immediate payment. Former smokers chose similarly to people who had never smoked. When the reward was cigarettes rather than money, having to wait reduced its value even more for participants who smoked.

This tendency was also linked with treatment outcomes. In a study of 131 people treated with 6 weeks of cognitive behavioural therapy and 8 weeks of nicotine patches, those who valued delayed rewards less before treatment went back to smoking sooner. The link remained after taking into account the strength of dependence and stress levels. In another study, 48 women stopped smoking during pregnancy, and the same tendency measured at the start predicted which of them would be smoking six months after giving birth.

That is why the addiction therapist does not base conversations with the patient only on diseases that may develop in 20 years' time. Together they set goals for the next few hours and days, for example getting through the first break at work without a cigarette. The patient also writes down changes they notice quickly, such as food tasting better or money staying in their wallet.

Yes. Smokers develop psoriasis more often, and in people who have it, smoking is linked with more severe disease. Psoriasis is a chronic inflammatory disease in which red, scaly patches form on the skin, most often on the elbows, knees, scalp and lower back.

An American study followed 78,532 nurses for 14 years and recorded 887 new cases. Compared with women who had never smoked, the risk of developing the disease was 78 percent higher in smokers and 37 percent higher in former smokers. The more years had passed since quitting, the lower the risk. In the first 10 years after quitting, the risk was 61 percent higher, between 10 and 19 years 31 percent higher, and after 20 years it no longer differed significantly from that of women who had never smoked.

At a dermatology hospital in Rome, 818 patients with psoriasis were examined. In people who smoked more than 20 cigarettes a day, severe disease was more than twice as common as in those who smoked no more than 10. A hospital in Shanghai followed 192 patients treated with biological medicines. After 12 weeks, non-smokers had about a 2.6 times greater chance of a reduction in skin lesions of at least 75 percent. All these studies were observational, so they do not prove that smoking causes these differences.

Psoriasis is not a contraindication to cytisine or nicotine patches, but it affects how they are used. According to the manufacturer's recommendations, the NiQuitin patch is applied only to healthy skin that is not broken, red or irritated. People with atopic dermatitis or eczema should use it with caution. Rash is one of the very common side effects of Desmoxan, which is why a patient with psoriasis tells the doctor about any new skin change.

After many years without cigarettes, the risk of heart failure in most former smokers returns to the level of people who have never smoked. Heart failure means that the heart pumps too little blood, which causes breathlessness, getting tired quickly and swollen legs.

An American study followed 4482 people over 65 who did not have heart failure at the start for 13 years. Former smokers who had not smoked for more than 15 years developed it as often as people who had never smoked and did not die more often than them. The exception was people who had previously smoked very heavily, the equivalent of a pack a day for at least 32 years. They developed heart failure 45 percent more often than people with no history of smoking. Even so, they died during the study about a third less often than people who had not stopped smoking.

Patients at Nasz Gabinet in Wałbrzych do not have to quit alone: they receive medical support and, with the treatment plan, support from an addiction therapist. To start, choose a course or plan in the app and book a consultation at ul. Młynarska 24 or by video.

Patients start by booking at Nasz Gabinet in Wałbrzych, ul. Młynarska 24, or a video consultation in the app. The clinic is open 7 days a week from 8:00 to 20:00, including weekends. No referral is needed. Two treatment options are available, both purchased in the app. The Anti-Nicotine Course for PLN 350 includes a medical consultation with an e-prescription for the selected medicine. The Anti-Nicotine Treatment Plan for PLN 2499 includes a consultation, prescriptions for 3 months of medication and 10 addiction therapy sessions.

To assess nicotine dependence, the doctor asks how long and how much the patient has smoked, about past and current illnesses, and about all medicines taken. This informs the choice of stop-smoking medication and the agreed date of the last cigarette. Patients receive instructions specifying the medicine, the number of doses on subsequent days and their timing. They fill the doctor's e-prescription at a pharmacy and pay separately for the medicine.

During treatment, the doctor checks at follow-up how the medicine is tolerated and whether the dose needs changing. Patients with the treatment plan also attend addiction therapy sessions.

Each of the available medicines has several decades of history behind it, and cytisine is the oldest. Effectiveness data come from a review of 319 studies published in 2023 by Cochrane, an international scientific organisation that pools the results of clinical trials and assesses how reliable they are. We checked prices in 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.

Where does cytisine come from?

Cytisine is an alkaloid from plants of the legume family, obtained mainly from laburnum seeds. During the Second World War, plants containing it were used as a tobacco substitute, and in Central and Eastern Europe it has been sold as a stop-smoking medicine for more than 50 years. Today, Desmoxan, Tabex and Recigar tablets are available in Polish pharmacies. Each tablet contains 1.5 mg of cytisine.

In the brain, cytisine binds to the receptors that nicotine acts on and stimulates them more weakly than nicotine does. As a result, the patient feels the lack of nicotine less, and smoking during treatment gives less pleasure than before. At first, tablets are taken 2 hours apart, which means up to 6 a day, and the interval gets longer at each stage, until from day 21 to day 25 just 1 or 2 tablets a day are enough. Smoking must stop by day 5 of treatment. Among 100 people taking cytisine, about 7 more quit smoking than among 100 people given a placebo. A pack of 100 tablets, enough for the whole course, cost from PLN 40 to PLN 78.

How were nicotine gum and patches developed?

The idea for the gum came from two doctors at Lund University, who noticed that submarine crews coped badly with enforced breaks from smoking. The chemist Ove Fernö of the Swedish pharmaceutical company Leo worked on the gum from 1969, the first description in a scientific journal appeared in 1973, and the gum went on sale in 1978. The patch has a shorter history. In 1984, American researchers applied a solution containing 9 mg of nicotine to the forearm of a single volunteer. After half an hour, nicotine was detected in his saliva, his heart rate rose by 15 beats per minute, and for 2 hours the nicotine level stayed similar to that seen when smoking cigarettes.

Pharmacies currently offer NiQuitin Clear patches, worn around the clock, and Nicorette Invisipatch, removed before sleep. A new patch is applied once daily, and NiQuitin patches are not used for longer than 10 weeks. Patches increased the number of non-smokers by about 2 per 100 people. Nicorette Classic Gum, NiQuitin MINI lozenges and Nicorette Spray are generally used when cravings increase. For fast-acting nicotine formulations, the pooled result was about 3 additional non-smokers per 100 compared with placebo or no medicine. When Nicorette Classic Gum or NiQuitin MINI 4 mg lozenges are used alone, the daily limit is 15 pieces. Spray has three limits: 2 sprays at once, 4 per hour and 64 per day. Ten weeks of NiQuitin patches cost PLN 606–930, a 150-dose spray PLN 62–85, and 105 pieces of 4 mg gum PLN 78–100.

What links varenicline with cytisine, and where did bupropion come from?

Researchers at Pfizer began their search for a new medicine with cytisine. Its derivatives did not live up to expectations, so varenicline, first made in 1997, was built on a different molecular framework. It works in a similar way, however, as it also stimulates the same receptors more weakly than nicotine. Among people treated with varenicline, sold as Champix, about 8 more per 100 quit smoking than without medication. In May 2021, a carcinogenic impurity, N-nitroso-varenicline, was found in varenicline tablets in amounts exceeding the limits set by the European Medicines Agency. Batches of the medicine were recalled, which led to shortages of varenicline. In September 2026, none of the pharmacies we checked had Champix.

Bupropion was developed as an antidepressant. In a study published in 1997, 615 smokers took bupropion at one of three doses or a placebo for 7 weeks. After a year, 23.1 percent of people taking 300 mg a day and 12.4 percent of those taking placebo were not smoking. In the review of studies, bupropion increased the number of non-smokers by about 3 per 100. Varenicline and bupropion require a prescription, and the marketing authorisation for Zyban, a bupropion medicine, expired in Poland in December 2023.

The Anti-Nicotine Treatment Plan includes 10 addiction therapy sessions. The Anti-Nicotine Course does not include them, as it is based on a medical consultation and medication. Sessions take place by video in the app, so patients at Nasz Gabinet in Wałbrzych do not need to travel to ul. Młynarska for them. Read more about the therapist's work on our page about addiction therapy in Wałbrzych.

The first conversations explore smoking itself: when, where and why patients reach for a cigarette, and their own reasons for wanting to stop. One approach is motivational interviewing, which helps patients examine their doubts and desire for change. Subsequent sessions prepare for the quit date, from which patients stop completely. We align it with the selected medicine's schedule, while patients and therapists develop an individual plan for strong cravings. During this period, the doctor assesses withdrawal symptoms and changes treatment when needed; follow-up dates are agreed individually.

After quitting, patients discuss changing daily routines, managing stress and emotions without cigarettes, and lifestyle changes with the therapist. Concerns about weight gain can also be discussed. Later work helps maintain new habits and see oneself as a non-smoker. Patients also prepare for a possible lapse so one cigarette does not lead to a return to smoking.

Yes, to some extent. The Nasz Gabinet app reminds the patient about every dose of medicine prescribed by the doctor, which for cytisine means 6 tablets on the first days and 1 or 2 towards the end of treatment. The patient ticks off a swallowed tablet or an applied patch in the app with a single tap. Once a day, the app randomly picks a dose that the patient records themselves taking on their phone, and medical staff check the video. The patient does not record gum, lozenges or spray, which they use when a nicotine craving strikes.

Medical staff set the reminder times according to the treatment plan. If the reminder times do not suit the patient's day, for example because they get up early for work, the patient can move them. They have 2 days from when the medicine is assigned to do this and can only do it once. The number of doses stays the same. Any further change of times is made by medical staff when the patient contacts us.

The app is free to download. Patients also purchase their treatment programme within it, choosing the Anti-Nicotine Course or Anti-Nicotine Treatment Plan. Both give access to the reminders described above. If help is needed with purchasing or installation, just call us.

• We do not recommend sucking glucose tablets instead of taking a medicine. In London, 928 people who were quitting smoking were randomly given glucose tablets or sweet sorbitol tablets and asked to suck at least 12 a day for 5 weeks. All of them had group psychological support, and roughly half also took nicotine medicines or bupropion. Six months without cigarettes were achieved by 14.6 percent of people taking glucose tablets and 13.4 percent of those taking sorbitol tablets, and the difference was not statistically significant. The authors considered the better result for glucose in people also taking medicines to require further research.
• We do not suggest inhaling essential oils instead of smoking a cigarette. In the only study we found, 48 smokers, after a night without cigarettes, inhaled for 3 hours from a device containing black pepper oil, menthol or an empty cartridge. When inhaling black pepper oil, the urge to smoke was lower than in the other groups, but nobody checked whether participants later stopped smoking.