What's the other major drug used in a smoking cessation program?
Bupropion, an antidepressant (also prescribed under the brand name Wellbutrin), is the other FDA-approved drug and also effective as a smoking cessation aid. It's less effective for most people than varenicline. Bupropion is particularly effective in people who get depression when they quit smoking.

What are the side effects of these smoking cessation medications?
Both varenicline and bupropion have an FDA black-box warning [the federal agency's strongest] on the packaging, so discuss this with your doctor. There have been [some] people who have gotten depressed using these medications, particularly if they have a history of depression.

Their biggest side effects are sleep disruption and some nausea, but most people tolerate it better over time. It's not common for people to stop it because of these side effects. Nausea can also be a side effect of NRT – think back to sneaking your first cigarette and how you probably were nauseous. If the patient experiences nausea we would decrease the dose of nicotine in the treatment.

What withdrawal symptoms can women expect when in a smoking cessation program?
Quitting smoking results in a myriad of withdrawal symptoms, including irritability, difficulty concentrating, disturbed sleep, urges to smoke, increased appetite, and, for some people, depressed mood. There is probably a degree of self-medication in smoking because it releases dopamine. Thus, when you quit smoking, and you're not stimulating dopamine release, there's an adjustment period.

But we can offer patients an incredibly powerful bridge from using deadly cigarettes to being an ex-smoker – through the use of medicine for 8-12 weeks on average together with counseling.