ABC News' Dr. Tim Answers Questions About Smoking

Question: I have stopped smoking several times using Zyban. Soon after I stopped taking it, I start smoking again. My question is: Would side effects from the long term use of Zyban be any worse than cigarettes? Zyban (Wellbutrin) really does work.

-- Ron Walker, Gastonia, NC

Answer: As you might know, Zyban is the same chemical compound as the antidepressant, Wellbutrin -- both are bupropion. Patients have taken Wellbutrin for years at a time without long-term side effects. I recommend my patients to continue taking Zyban indefinitely in situations such as yours. The benefits far outweigh the risks. You can do this more cheaply by using generic bupropion, which, like Zyban, is available in 150 mg tablets taken twice a day.

Source: Tobacco Intervention Programs, Wake Forest University Baptist Medical Center

Question: Is there any other drugs besides Zyban that can help in smoking cessation? My insurance will not pay for Zyban.

-- Gary Vornheder, Chicago, IL

Answer: There are a number of other medications. Of course, easiest to obtain are the nicotine patch and the nicotine gum, both of which are over-the-counter. Your doctor can also prescribe the nicotine inhaler or nicotine nose spray, but these are somewhat expensive, and -- if your insurance does not pay for Zyban -- I doubt your insurance will pay for these.

There are three other medications that can be used: nortriptyline, clonidine, and mecamylamine. Like Zyban, Nortriptyline is also an antidepressant; clonidine and mecamylamine are blood pressure medicines. All three will double your success rate in quitting, just as Zyban does.

Source: Tobacco Intervention Programs, Wake Forest University Baptist Medical Center

Question: If nicotine is a drug, why is it that the FDA can control what drug companies put out that is harmful to our health, but not the tobacco industry?

Answer: This is a question that many experts in field have also posed. I think the answer is that tobacco has been freely available since the time of Columbus -- even before that by Native American tribes. There is also a very strong tobacco lobby that opposes such a move.

Along the same lines, the Environmental Protection Agency has categorized second hand smoke as a carcinogen, and many experts therefore advocate the regulation of cigarette smoking on this basis. This is happening in many communities, restaurants, sports arenas, airports and other public places.
Source: Tobacco Intervention Programs, Wake Forest University Baptist Medical Center

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