Nicotine dependence treatment Warsaw

Treatment in Warsaw starts with a PLN 250 medical consultation at the practice at Warowna 1/U4 in Mokotów or online. No referral is needed, and the patient does not have to give up cigarettes beforehand. After the consultation, the patient takes the medicine chosen by the doctor and has online sessions with an addiction therapist.

What do we establish at the first consultation?

First, we establish how strong the dependence is. The number of cigarettes smoked a day and how soon after waking up the patient lights the first one help decide, among other things, whether one form of nicotine replacement therapy is enough or whether a patch combined with gum would work better. We also ask whether the patient drinks alcohol or is being treated for alcohol dependence, because alcohol often goes hand in hand with smoking and needs to be taken into account in the plan to quit.

Before choosing a medicine, the doctor checks what conditions the patient has, whether there are any contraindications and what medicines they take. We set the quit date only once the doctor has decided whether the patient will be treated with a medicine and, if so, which one.

Part of the dependence comes from nicotine itself. After a puff of smoke, nicotine reaches the brain within a few seconds, stimulates nicotinic receptors and increases the release of dopamine. The brain of someone who smokes every day gets used to nicotine, so when its level drops, irritability, anxiety and cravings appear. The World Health Organization classifies nicotine dependence, also called nicotine addiction, as a disease, under code F17.2 in ICD-10 and under code 6C4A.2 in ICD-11.

The other part is made up of learned associations. Smokers usually light up after a meal, with coffee, while drinking alcohol or with friends who smoke, and after many repetitions these situations trigger the urge to smoke on their own, even long after withdrawal symptoms have passed. Even irritability can become linked with cigarettes. A smoker learns that a cigarette relieves the irritability caused by a lack of nicotine and then reaches for one whenever they feel irritable for any other reason, for example after an argument.

Nicotine dependence is much more common in people with mental illness and in people dependent on alcohol or other substances. According to a review of research on nicotine dependence, this is probably due to a shared genetic background, the way nicotine eases some symptoms of mental illness, and components of smoke that block enzymes in the brain that break down dopamine. That is why, when a patient quits smoking, we take into account their treatment for alcohol dependence or their psychiatric treatment.

Stop-smoking medicines contain one of four substances: cytisine, nicotine, varenicline or bupropion. For each substance, we give example products, doses and how it works. We also give the results of an analysis of 319 studies prepared by Cochrane: the percentage of people who were not smoking after at least six months in groups using the medicine and in groups without it. Cochrane is an independent scientific organisation that gathers and compares the results of studies on a given topic.

Cytisine

Cytisinicline, also known as cytisine, is the active ingredient of Desmoxan, Tabex and Recigar, at 1.5 mg per tablet or capsule. Its structure resembles nicotine; it stimulates nicotinic receptors in the brain more weakly than nicotine and gradually pushes nicotine out of them, which eases withdrawal symptoms. After six months, 13 percent of people treated with cytisine were not smoking, compared with 6 percent without medication.

Most cytisine products are sold without a prescription. The course lasts 25 days and costs about PLN 40 to 78. For the first 3 days, the patient takes one tablet every 2 hours, up to 6 tablets a day, then less and less often, and stops smoking by day 5 at the latest. Cytisine is not taken during pregnancy or breastfeeding or after a recent heart attack or stroke. It is not recommended for people under 18 or over 65, because it has been poorly studied in these age groups.

Nicotine patches

NiQuitin Przezroczysty is a 24-hour patch that releases 7, 14 or 21 mg of nicotine a day, and Nicorette Invisipatch is a 16-hour patch in strengths of 10, 15 or 25 mg. Nicotine is absorbed through the skin and stays in the body at a steady level, lower than after smoking a cigarette, which reduces the need to smoke. After six months, 8 percent of people using a patch were not smoking, compared with 6 percent without medication.

Patches are sold without a prescription. For people who smoke more than 10 cigarettes a day, a course of NiQuitin patches lasts 10 weeks: 21 mg for 6 weeks, 14 mg for 2 weeks and 7 mg for 2 weeks, and the whole course costs about PLN 606 to 930. We also consider a patch for people who cannot take cytisine, and in people with heart disease we choose it with care.

Nicotine gum, spray and lozenges

Nicorette Classic Gum contains 2 or 4 mg of nicotine, Nicorette Spray 1 mg per spray, and NiQuitin MINI lozenges 1.5, 2 or 4 mg. The nicotine is absorbed through the lining of the mouth and works faster than nicotine from a patch, so patients reach for these products when a sudden craving hits, and strongly dependent people can combine them with a patch. All of them are sold without a prescription. After six months, 9 percent of people using these forms of nicotine were not smoking.

Varenicline

Varenicline, at 0.5 or 1 mg per tablet, is the active ingredient of Champix, a prescription medicine. In September 2026, it was not available in the pharmacies we checked. Varenicline partly stimulates the same nicotinic receptors as cytisine and makes it harder for nicotine from cigarettes to stimulate them fully. After six months, 14 percent of people treated with varenicline were not smoking, compared with 6 percent without medication.

Bupropion

Zyban, a prescription medicine, contained 150 mg of bupropion hydrochloride in a prolonged-release tablet, and its marketing authorisation expired in December 2023. Bupropion blocks the reuptake of noradrenaline and dopamine in the brain, which means these substances, which carry signals between nerve cells, act for longer. According to the manufacturer of Zyban, however, it is not known exactly how the medicine helps people stop smoking. After six months, 9 percent of people treated with bupropion were not smoking.

Sessions with an addiction therapist focus on the everyday situations in which the patient has smoked until now, such as breaks at work, driving, stress or meeting friends who smoke. The patient decides what they will do in each of them, and in the next session talks about what they managed to change and when they came closest to reaching for a cigarette.

If the patient takes a medicine and also talks to a therapist, the chance of quitting is higher than with medication alone. In studies, there were usually 4 to 8 such meetings. Sessions take place online, so the patient connects with the therapist from home or from work. According to the price list, one session costs PLN 250.

You can quit smoking while being treated for alcohol dependence and while receiving psychiatric treatment. Studies do not show that quitting smoking puts abstinence at risk or, on average, makes mental health worse. The doctor does, however, take into account the patient's current treatment and the medicines they take.

Does quitting smoking put abstinence from alcohol at risk?

Among people dependent on alcohol or drugs, the proportion of smokers is two to four times higher than in the population as a whole. Cochrane analysed 35 studies involving 5,796 such people. In these studies, help with quitting smoking was not linked to any difference in the proportion of patients who stayed abstinent from alcohol and drugs. The studies included people both during and after treatment.

In the same studies, stop-smoking medicines increased the proportion of people who stopped smoking, especially when the patient also talked to a therapist. Talking therapy on its own, without medication, did not significantly change the proportion of people who stopped smoking. The authors of the review rate the quality of these data as low.

Alcohol makes quitting harder, because for many smokers a cigarette has gone with drinking for years. With a person who is giving up drinking and smoking at the same time, the therapist talks through the situations in which they used to drink and smoke. We treat alcohol dependence at the same practice, and we describe that treatment on the page about alcohol addiction treatment in Warsaw.

Does quitting smoking harm mental health?

In a summary of the results of 102 studies, people who quit smoking later had, on average, a slightly better mood and fewer symptoms of anxiety than people who kept smoking. This was also true for people with mental illness. The certainty of these data was rated differently, from very low to moderate.

When a patient stops inhaling tobacco smoke, the blood levels of clozapine, olanzapine and fluvoxamine rise, even if they use a nicotine patch. That is why the patient tells their psychiatrist about the quit date in advance. Low mood can also be a symptom of nicotine withdrawal, and the Summary of Product Characteristics for cytisine warns that such low mood can rarely lead to suicidal thoughts and suicide attempts. The patient tells the doctor about any marked change in mood, and suicidal thoughts need immediate medical help, without waiting for a scheduled appointment.

The main purpose of the Nasz Gabinet app is to help the patient take their medicine regularly. It sends a reminder for every dose in the treatment plan and shows when the next one is due. This matters especially with cytisine, because over the 25 days of treatment the number of tablets a day drops from 6 to 1 or 2, and the gaps between them get longer.

In the app, the patient can also book online consultations and sessions with an addiction therapist, without travelling to Mokotów. The doctor sets the medicine and dose at the appointment, so the patient tells the doctor about any symptoms they think are linked to the medicine. To start the treatment programme in the app, simply contact Nasz Gabinet Warsaw. Our team will help you buy access and install the app.

• We do not offer acupuncture or laser therapy. An analysis of 38 studies found no reliable evidence that acupuncture, acupressure or laser therapy help people stop smoking for at least six months.
• We do not use electrostimulation. In the same analysis, electrostimulation worked no better than a sham procedure.

The earlier a patient stops smoking, the more they gain. In a UK study that followed more than a million women for about 12 years, women who kept smoking were roughly three times as likely to die during that time as women who had never smoked. Even with fewer than 10 cigarettes a day, the risk of death was twice as high. Women who quit before the age of 40 avoided more than 90 percent of this extra risk, and those who quit before 30 avoided more than 97 percent.

In Warsaw, no patient is left to quit alone. The doctor chooses a medicine and takes other treatment into account, such as treatment for alcohol dependence or psychiatric treatment. The addiction therapist talks through with the patient the situations in which they used to reach for a cigarette, and the app sends reminders about doses. If the first weeks are difficult, the patient can book an earlier consultation or session, online or at the practice at Warowna 1/U4 in Mokotów.