Warowna 1/U4, 02-654 Warszawa
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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.
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.
Patients in Warsaw do not have to quit alone. If the first weeks are difficult, they can arrange an earlier medical consultation at ul. Warowna 1/U4 in Mokotów or by video in the app. Those with the treatment plan also discuss difficult moments in addiction therapy sessions.
Treatment in Warsaw starts with a medical consultation at ul. Warowna 1/U4 in Mokotów or by video in the app. No referral is needed, and patients do not have to stop smoking beforehand. Those choosing medication without therapy sessions can purchase the Anti-Nicotine Course for PLN 350, in which the doctor issues an e-prescription during the consultation. The Anti-Nicotine Treatment Plan for PLN 2499 combines a consultation and prescriptions for 3 months of treatment with 10 video sessions with an addiction therapist. Both options are purchased in the app; medication is paid for separately at a pharmacy.
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.
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.
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.
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.
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, 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.
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.
People can quit smoking during treatment for alcohol dependence or while receiving psychiatric care. In the studies described below, stop-smoking support did not make it harder to remain abstinent from alcohol or drugs, and people who quit did not have worse moods than those who continued smoking. The doctor nevertheless considers the patient's existing treatment and medication.
Smoking is two to four times as common among people dependent on alcohol or drugs as in the general population. A review of 35 studies involving 5796 such participants found that stop-smoking support was not associated with a difference in the proportion remaining abstinent from alcohol and drugs. 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.
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.
In the first sessions, patients explore their own reasons for wanting to stop and why they currently reach for cigarettes. The therapist uses approaches such as motivational interviewing, a conversation in which patients identify their doubts and consider their reasons for change.
Sessions then address everyday situations in which patients used to smoke, such as work breaks, driving, stress or meeting friends who smoke. Patients decide what to do in each situation, then discuss at the next session what changed and when they came closest to smoking. They also prepare for the quit date, from which they stop smoking completely, and find ways to manage cravings. Conversations cover changing routines, managing stress and emotions, lifestyle and concerns about weight gain if the patient has them.
Once patients are no longer smoking, sessions help maintain new habits and adjust to seeing themselves as non-smokers. They also discuss what to do after smoking one cigarette, so a lapse does not become a return to smoking.
The Anti-Nicotine Treatment Plan includes 10 addiction therapy sessions. Combining medication with therapist support increases the chance of quitting compared with medication alone. Studies usually involved 4–8 sessions. Sessions take place by video in the app, so patients can connect from home or work. Alongside therapy, the doctor assesses withdrawal symptoms and provides support particularly in the first smoke-free weeks. Follow-up dates are arranged individually.
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.
Patients purchase a course or treatment plan in the app and book video consultations without travelling to Mokotów. Those with the plan also book addiction therapy sessions there. The doctor sets the medicine and dose at the consultation, so patients should report symptoms they associate with medication. Contact Nasz Gabinet in Warsaw if help is needed with purchasing or installation.
Your treatment is led by a doctor specialising in addiction medicine together with certified addiction therapists. Meet our team.
Medical doctor, addiction treatment specialist
Lek. med. Bogdan Bas has specialised in addiction treatment for over 15 years, combining medicine and psychotherapy into a modern treatment method.
Doctor of psychology, certified addiction therapist
Graduate of the University of Wrocław.
Psychologist, certified addiction psychotherapy specialist
Graduate of SWPS University of Social Sciences and Humanities.
Book your first appointment
A 3-month treatment plan for PLN 499: a medical interview in the chat, an e-prescription for the medicine and reminders for every tablet in the app. Consultations with a psychologist are paid separately.
