{ "schema_version": 1, "kind": "condition", "id": "smoking-cessation", "name": "Smoking Cessation", "category": "chronic", "sources": "WHO Guidelines for the Treatment of Tobacco Dependence 2021 · Zyban 150 mg prolonged release tablets SmPC sections 4.2-4.4 (eMC product 3827) · Nicorette 2 mg Gum SmPC sections 4.2 and 4.4 (eMC product 1089)", "review_status": "reviewed", "verified_against": "Nicorette 2 mg Gum SmPC sections 4.2 and 4.4 (eMC product 1089) · Zyban 150 mg prolonged release tablets SmPC sections 4.2-4.4 (eMC product 3827)", "verified_date": "2026-08", "treatments": [ { "id": 1655, "generic": "Nicotine", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 2.0, "adult_dose": "Chew 2 mg gum when urge occurs (up to 15 pieces daily; 4 mg if >20 cigarettes/day)", "adult_duration": "8-12 weeks", "dose_source": "Nicorette 2 mg Gum SmPC sections 4.2 and 4.4 (eMC product 1089)", "rationale": "Nicotine gum is a form of nicotine replacement therapy that supplies nicotine without the tar and combustion products of cigarettes, easing withdrawal symptoms and cravings during a quit attempt.", "cautions": [ "Caution in recent myocardial infarction, unstable angina, or severe arrhythmia.", "Use 'chew and park' technique (chew slowly until tingling, then park between cheek and gum).", "Avoid acidic beverages (coffee, juice) 15 minutes before and during use.", "Chew and rest, not chew continuously: chew until the taste is strong, then park the gum against the cheek until it fades, and repeat for about half an hour. Chewing it like ordinary gum swallows the nicotine and gives hiccups and heartburn instead of a blood level.", "Fifteen pieces a day is the ceiling. Coming off the 4 mg, stepping down to the 2 mg helps.", "It sticks to dentures and can damage them." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Adolescents >=12 years: 2 mg gum under medical supervision", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": [ { "label": "12 years and over", "age_min_months": 144, "age_max_months": 216, "dose_text": "2 mg gum, under medical supervision" } ], "peds_doses": null, "brands": [ { "trade_name": "NICORETTE FREHMINT GUM 2 MG 30 PIECES", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MCNEIL PRODUCTS LTD. > JOHNSON & JOHNSON", "price_egp": 161.0, "pack_count": null, "unit_price": null, "strength_mg": 2.0, "exact_strength": true, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "smoking-cessation" }, { "id": 1656, "generic": "Bupropion", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 150.0, "adult_dose": "150 mg once daily for 6 days, then 150 mg twice daily (8 hours apart)", "adult_duration": "7-9 weeks (target stop date set in week 2)", "dose_source": "Zyban 150 mg prolonged release tablets SmPC sections 4.2-4.4 (eMC product 3827)", "rationale": "Atypical antidepressant that reduces nicotine craving and withdrawal by modulating dopamine and noradrenaline reuptake in the brain; a non-nicotine pharmacotherapy option for smoking cessation.", "cautions": [ "CONTRAINDICATED in patients with epilepsy, eating disorders, or CNS tumour.", "Monitor blood pressure and mental health changes.", "Set the quit date inside the first two weeks, ideally the second - the drug is started before the cigarettes stop, not after.", "Seven to nine weeks in total. If nothing has changed by seven weeks, stop rather than continue.", "Roughly one person in a thousand has a seizure at the full 300 mg. That is why the contraindications are absolute: any history of seizures at all, bulimia or anorexia now or ever, bipolar disorder, an MAOI within fourteen days, or a patient coming off alcohol or benzodiazepines abruptly.", "Never more than 150 mg in one dose or 300 mg in a day, and at least 8 hours between them.", "There is a risk of insomnia; avoid second dose near bedtime." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Not recommended under 18 years", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "BUPROFUTAL SR 150 MG 30 TABS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "FUTURE PHARMACEUTICAL INDUSTRIES", "price_egp": 152.0, "pack_count": 30, "unit_price": 5.07, "strength_mg": 150.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "VIXADEP 150 MG 30 S.R.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MARCYRL PHARMACEUTICAL INDUSTRIES (MPI)", "price_egp": 221.0, "pack_count": null, "unit_price": null, "strength_mg": 150.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "WELLINTA 150 MG 30S.R.F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "HOCHSTER PHARMACEUTICAL INDUSTRIES > ELIXIR PHARMA", "price_egp": 291.0, "pack_count": null, "unit_price": null, "strength_mg": 150.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "smoking-cessation" } ] }