Eletta Hansen: Hello, my name is Eletta Hansen. I am a registered nurse and a Certified Tobacco Treatment Specialist here at Medicorp Health System in Fredericksburg, Virginia. Today we are talking about how to quit smoking and now I am going to answer questions about the approved medications that are available to help you quit. Host: What are the medications that help you quit smoking? Eletta Hansen: There are seven medications that have been approved by the FDA for smoking cessation. Five of the seven are nicotine replacement, the last two work differently in our bodies. The first three that we will discuss are across the counter and do not require physician prescription. They are all designed to give you a slow sustained release of clean nicotine manufactured in the lab, that is slowly absorbed by the body and will gradually wean you off, the nicotine of which you become so dependent. The Nicotine Patch is the first aid we will discuss. Many of you know about this. The nicotine patch is a three step process. The patches come in 21, 14 and 7 mgs. The plan is to use the 21mg patch for six weeks. Place the new patch somewhere on the upper body each day. If you have any difficulty with skin, skin sensations, skin irritation, clean the area and apply cortisone cream but never put a patch in the same place, a successive day. After six weeks, drop down to the 14mg patch, again a new patch every day. After two to four weeks drop down to step three, the 7mg patch, a new patch every day. The patches can be placed anywhere on the upper body and as I said before it is important that you would not place the patch in the same place as a previous one had been. It is important that you use the patches long enough. Many people who have been unsuccessful with the patches will use them for one or two days. If you smoke 10 or more cigarettes a day, it is important that you do the full three step 12 to 14 week program as recommended by the manufacturer of the nicotine patch. The second approach is the Nicotine Lozenges. The idea is to hold the lozenge in the mouth and to slowly allow the nicotine to be released, to be absorbed through the lining of the mouth. The third is the Nicotine Gum. Again, it is designed to be chewed but not like regular chewing gum. Break the gum, park it on the side of your mouth and allow the nicotine to be slowly released and absorbed through the lining of the mouth. Both the lozenge and the gum come in 2 and 4mg strengths depending upon the number of cigarettes, you smoke per day and/or the time of your first cigarette in the morning after awakening. The fourth product requires a prescription, it is Nicotine Nasal Spray absorbed through the mucous lining of the nose. Not to be sniffed, but just to be placed on the lining and allowed to absorb through the nostrils. The fifth is the Nicotine Inhaler. This is actually where you have a pile of liquid nicotine in a plastic holder. It looks much like a cigarette and you actually puff or smoke the nicotine inhaler. Many people find this to be very beneficial because it emulates the hand and mouth motion that you have become accustomed to as a cigarette smoker. The sixth product is Bupropion, not a nicotine replacement. Bupropion is also marked as Zyban for smoking cessation, it is an oral medication. You are allowed to smoke for the first seven days while taking the medication to give it time to build up in the bloodstream. Day eight is quit day and that is the day, you are to get rid of your cigarettes, your lighters, your matches. The Bupropion acts differently and that it helps to release more of the chemical called Dopamine which is the chemical that gives your body the sense of pleasure something that the cigarette has also done for you. It helps to avoid getting the blues, if you will. A little bit of depression that often accompanies with smoking cessation. The seventh product is Chantix. It is a medication that acts even more differently than the others. The Chantix essentially blocks the nicotine receptors in the brain, so that your body cannot absorb the nicotine. So, it helps to break the physical addiction to the nicotine. The Chantix is designed like the other products to be taken over a 12 week period. Some physicians are prescribing an additional 3 months, if patients are at high risk for relapse.