Stop smoking treatments

Giving up smoking is one of the best things you can do to improve your asthma, or improve your child’s asthma.

Stop smoking treatments in brief

  • One of the best things you can do to improve your asthma, or your child's asthma, is give up smoking. If you stop, your asthma medicines will be able to do their job properly, you'll have fewer asthma symptoms, such as coughing and breathlessness, and you'll cut your risk of a potentially life-threatening asthma attack.
  • Increase your chances of quitting by getting support and motivation from friends, family, and your GP, and talking to your GP or smoking specialist about finding the safest stop smoking treatment for you.
  • Stop smoking treatments include nicotine replacement therapy (NRT), such as skin patches, gum, tablets, lozenges, inhalators, mouth sprays and nasal sprays, a course of Champix® tablets, a course of Zyban® tablets and complementary therapies, such as hypnotherapy.

Get the help you need

The good news is there's a lot of support out there for people who want to quit, including treatments and medicines to help you. Using your local NHS smoking cessation services is something the UK's respiratory experts, the British Thoracic Society, recommend for people with asthma. It's a good way to get the stop smoking support and advice along with the right smoking treatment for you.

Here's an introduction to the stop smoking treatments available.

How do stop smoking treatments work?

Using stop smoking treatments doubles your chances of successfully giving up smoking. This is because the treatments all work by reducing your craving to smoke - cutting the craving is a key factor in successfully quitting smoking.

But none of these treatments is a miracle cure. You'll still need to be ready to quit and ready to work at it. So:

  • Don't go it alone - get support and motivation from friends, family, and your GP. You'll get the best results from any stop smoking treatment if you use it alongside NHS support services
  • Before starting any of the following stop smoking treatments here, make sure you talk to your GP, smoking specialist or pharmacist to find the safest one for you
  • Always let your GP know if you've noticed any unusual symptoms, or your asthma getting worse, after using any stop smoking treatment.

NRT - Nicotine replacement therapy

What is it?

Nicotine Replacement Therapy (NRT) provides your body with slow release nicotine. Nicotine products are viewed as a safe and effective way for most people to cut down or stop smoking.

Is NRT OK for people with asthma to use?

NRT is safe for most people with asthma when used as a short term stop smoking treatment. Using NRT products to help you quit is much less risky to people with asthma than continuing to smoke. NRT products don't contain the tar, carbon dioxide and other toxic chemicals that cigarettes do. But the best option is to give up all forms of nicotine and so we don't recommend using NRT products as a replacement for cigarettes in the longer term.

If you're thinking of starting NRT, talk it through with your GP, smoking specialist or pharmacist first particularly if you:

  • have a heart or circulatory condition
  • are on regular medication
  • are pregnant (nicotine can affect your unborn child)
  • are breastfeeding (you can pass nicotine to your baby through breast milk)
  • are under 18 because there might be safer options for you

What kinds of NRT products are there?

You can choose from skin patches, gum, tablets, lozenges to use under the tongue, inhalators, mouth sprays and nasal sprays.

Some people find using more than one type of NRT product really helpful, for example, using patches to cut down background cravings for a cigarette, and a mouth spray for when you get a craving.

NRT products are available as an NHS prescription from your GP, or to buy over the counter at your pharmacy. Even if you pay for prescriptions it works out about a third cheaper to get NRT on prescription.

How long does it take to work?

You'll usually be given a 12-week course of NRT, before you reduce the dose, and then stop. Most people stop by three months.

If you've always smoked a lot you might find it takes longer than this and your GP or smoking specialist might suggest a 'cutting down' approach for you. This is when you're prescribed gum or an inhalator to use in between cigarettes, encouraging you to prolong the gap between cigarettes. If you do need to do this, it's good to have an end date in mind for not just quitting cigarettes but also quitting nicotine replacement, and stopping both within six months.

Possible side effects of NRT

Nicotine doesn't cause cancer - it's the other chemicals in a cigarette that cause cancer - but it is addictive. Any NRT regime needs to reduce the dose before eventually stopping, but most people don't become dependent on the nicotine in NRT products. In fact, a lot of people don't use it for long enough for it to work well.

Side effects from using NRT products include:

  • Increased heart rate
  • Increased blood pressure
  • Irritation of the nose, throat and eyes if you use a spray
  • Skin irritation if you're using patches

If you're using the right amount of NRT for you it can help avoid side effects from nicotine withdrawal, such as tremors and sweating, moodiness, anxiety and difficulty concentrating or sleeping. Talk to your GP, smoking specialist or pharmacist about the amount of NRT you need. For example, how many times do you need to chew nicotine gum in an hour to make it helpful?

Champix® (vareniciline)

Champix® tablets are available on prescription only. You'll usually be prescribed a 12-week course.

Is Champix® OK for people with asthma to use?

Asthma is not listed as a reason for not taking Champix®, however whenever you're starting a new treatment it's important to talk it through with your GP or asthma nurse first and make sure it won't make your asthma worse.

Champix® is not suitable for you if:

  • you're under 18
  • you're pregnant or breastfeeding
  • you have kidney disease
  • you have epilepsy
  • you're already taking Zyban®

How does Champix® work?

Champix® cuts down your craving to smoke - meaning you're less likely to have an urge for a cigarette so it can help you quit more easily. When you start on a course of Champix® you set yourself a quit day about 7-14 days into the course. It's really important that you do all you can, and get all the help and support you need, to stick to this quit day.

How long does it take to work?

Most people manage to quit in 12 weeks - this treatment has a high success rate. Studies suggest that Champix® quit rates are high first time round - you're three times more likely to quit compared to people who use no treatment at all.

Possible side effects of Champix® 

There are side effects, and it's important to talk these through with your GP, smoking specialist or pharmacist.

One of the possible side effects of Champix® that is particularly relevant for people with asthma is feeling breathless and coughing. Although this is not considered a common side effect it does affect up to 1 in 10 people taking Champix®.

Common side effects (which affect 1 in 10 people) include:

  • nausea
  • sore throat
  • headaches

For a full list of safety factors and possible side effects read the patient information leaflet.

Zyban® (bupropion)

Zyban® tablets are available on prescription only from your GP or smoking specialist. They are designed to support you in giving up smoking by reducing your cravings to smoke.

Is Zyban® OK for people with asthma to use?

Whenever you're starting a new treatment it's important to talk it through with your GP first and make sure it won't make your asthma worse.

Asthma is not listed as a reason for not taking Zyban®, however 1 in 1000 people experience difficulty breathing and wheezing. Although this is a rare side effect, it's worth talking it through with your GP or smoking specialist to make sure this treatment won't increase your risk of asthma symptoms.

Zyban® is not suitable for you if:

  • you're under 18
  • you're pregnant or breastfeeding
  • you have epilepsy, or a higher than usual risk of seizures
  • you have, or have ever had, an eating disorder
  • have severe depression/mental health issues - talk to your GP
  • you're already taking Champix®

How does Zyban® work?

Zyban® acts on the part of the brain that deals with addictive behaviour, so it can help with cravings and smoking habits.

Like other stop smoking treatments Zyban® also cuts down the withdrawal symptoms that often go with giving up smoking, making the whole process a bit easier.

How long is the course?

Your GP or smoking specialist will ask you to start taking Zyban® about a week before you stop smoking with your quit day set some time in the second week.

The course is about 7-9 weeks and you'll need to reduce the Zyban® dose gradually.

Possible side effects of Zyban®

Finding it hard to sleep is a very common side effect of taking Zyban® (affecting more than 1 in 10 people).

Other common side effects (affecting up to 1 in 10 people) include:

  • feeling nauseous
  • feeling shaky or dizzy
  • feeling depressed, anxious or moody

Side effects which are much less common (affecting 1 in 1000 people) include:

  • unusual wheezing or difficulty breathing
  • a higher risk of fits. This is why it is not recommended if you have epilepsy
  • if you have asthma and are using theophylline or some kinds of antihistamines, talk to your GP first because taking these and Zyban® can mean a higher risk than usual for seizures (fits). However, the risk of having seizures as a result of taking Zyban® is very small for most people

Always read the patient information leaflet that comes with the medicine for the full safety guidelines and side effects.

Are e-cigarettes an NHS stop smoking treatment?

As of January 2016, one brand of e-cigarette has been licensed as a medicine on the NHS by the Medicines and Healthcare Product regulatory Agency (MHRA). Although e-cigarettes are not risk-free, evidence shows they are much safer than tobacco smoking, and could help people to stop smoking altogether.

Dr Samantha Walker, Director of Research and Policy at Asthma UK, says: “People with asthma who want to stop smoking should talk to their GP or asthma nurse about all the options available to help them quit. More investment into research is still needed to find out the overall long-term effects of e-cigarettes so that people can make informed decisions about their health.”  

Why are people using them as a stop smoking tool?

E-cigarettes release doses of vaporised nicotine for the user to inhale and are increasingly being used by people wanting to quit cigarettes. 

There is evidence suggesting that e-cigarettes may help some people reduce the amount that they smoke, and some people have found them useful. Instead of reaching for a cigarette they can use an e-cigarette, which mimics the action of smoking but is less harmful than tobacco smoking. However, there is limited evidence to show that e-cigarettes are an effective smoking cessation aid.

Are there any risks or side effects?

E-cigarettes are not completely risk-free. We don't yet know their long-term effects on people both with and without asthma, but e-cigarettes do contain nicotine and we do know that nicotine is an addictive substance. 

Recent reports in the UK suggest the short-term use of e-cigarettes is significantly less harmful than tobacco, however the potential long-term risks of using them as an alternative to smoking are still unknown. This is an issue where more evidence is emerging all the time, and more research is needed on their effects for people with asthma.

At the moment, there aren't many rules about what ingredients can be used to flavour the vapour, and there's some evidence that some substances may cause an allergic reaction. For that reason we recommend that people with asthma who use e-cigarettes don't use any flavourings.

Is a nicotine inhalator the same thing as an e-cigarette?

No. A nicotine inhalator is a licensed stop smoking tool available on the NHS. The nicotine goes into the mouth, not the lungs and doesn't give such a strong 'hit' of nicotine as a cigarette. If you're unsure about using e-cigarettes, a nicotine inhalator may be an alternative option. Talk through your choices with your GP, pharmacist or stop smoking adviser.

What about complementary therapies?

Some people find complementary therapies, such as acupuncture and hypnotherapy, a useful support when they're giving up. But there's no clear evidence to prove they can help people quit.

However, lots of people find complementary therapies help them reduce stress. As people tend to smoke more when they're under stress, a complementary therapy which brings down your stress levels might work for you. Remember to make good use of the proven NHS services as well so that you have a package of support to up your chances of giving up smoking for good.

Not sure where to start?

Last updated November 2016

Next review due November 2019