Which Drug is Used in Tobacco? Nicotine and Cessation Medications

October 15, 2025 •

5 min read

According to the CDC, seven medications are approved by the FDA to help people quit smoking. This guide will clarify which drug is used in tobacco and detail the pharmacological treatments available to combat nicotine dependence, which is the addictive substance naturally found in the tobacco plant.

Quick Summary

Nicotine is the addictive substance in tobacco products. To quit, individuals can use FDA-approved medications like varenicline, bupropion, or nicotine replacement therapies (NRT) to manage withdrawal symptoms and cravings.

Key Points

Nicotine is the Addictive Substance: The primary drug found naturally in tobacco is nicotine, which is responsible for the addictive nature of smoking and other tobacco products.
FDA-Approved Cessation Aids: The FDA has approved seven medications to help people quit smoking, including nicotine replacement therapies, varenicline (Chantix), and bupropion (Zyban).
Variety of Delivery Methods: NRTs are available over-the-counter as patches, gum, and lozenges, and by prescription as inhalers and nasal sprays, offering different ways to manage cravings.
Varenicline's Dual Action: Varenicline works by both stimulating nicotine receptors to ease withdrawal and blocking nicotine from cigarettes, reducing the pleasure of smoking.
Bupropion's Mechanism: As an atypical antidepressant, bupropion affects brain neurotransmitters like dopamine and norepinephrine to reduce nicotine cravings and withdrawal symptoms.
Combination Therapy Often More Effective: Combining a long-acting NRT (patch) with a short-acting NRT (gum/lozenge) is often more effective than using a single product alone for managing cravings throughout the day.
Consult a Healthcare Provider: All pharmacological treatments for quitting tobacco, especially prescription medications, should be used under the guidance of a healthcare professional to ensure safety and select the most appropriate option.

The question, "Which drug is used in tobacco?" can be answered in two primary ways. The first is identifying the addictive substance inherently present in the tobacco plant, and the second is detailing the medications that are clinically used to help individuals overcome that addiction. Nicotine is the highly addictive chemical compound that occurs naturally in the tobacco plant and is therefore present in all tobacco products. It is this nicotine that keeps people using tobacco products, as it changes the brain's chemistry and creates cravings and dependence. However, it is the thousands of other harmful chemicals created during combustion that cause the most serious health effects. To combat this addiction, a range of prescription and over-the-counter medications are available to assist in the process of quitting.

Nicotine: The Addictive Drug in Tobacco

Nicotine is a potent psychoactive compound that rapidly affects the central nervous system. When inhaled from cigarette smoke, it reaches the brain within seconds, contributing to its high potential for dependence. Nicotine triggers the release of neurotransmitters, particularly dopamine, in the brain's reward pathways. This dopamine surge creates a temporary feeling of pleasure and reward, reinforcing the behavior of smoking. Over time, the brain becomes accustomed to this level of nicotine, leading to tolerance and dependence. When nicotine levels drop, withdrawal symptoms can occur, including irritability, anxiety, difficulty concentrating, and intense cravings for tobacco. The primary goal of smoking cessation medications is to counteract these withdrawal symptoms and cravings, breaking the cycle of dependence.

Pharmacological Treatments for Quitting Tobacco

There are three main categories of FDA-approved medications for smoking cessation: Nicotine Replacement Therapies (NRTs), Varenicline, and Bupropion SR. These pharmacological interventions significantly increase the chances of successfully quitting when combined with behavioral support.

Nicotine Replacement Therapies (NRTs)

NRTs work by delivering a controlled amount of nicotine to the body without the tar, carbon monoxide, and other toxic chemicals found in cigarette smoke. This helps to relieve some of the physical withdrawal symptoms and cravings, allowing the user to focus on the psychological and emotional aspects of quitting.

Over-the-counter (OTC) NRTs:

Patches: These are applied to the skin and release a slow, steady dose of nicotine over 16 or 24 hours. They are ideal for managing baseline cravings but don't provide a quick fix for sudden urges.
Gum: This is a fast-acting NRT chewed to release nicotine. The user chews until they feel a tingling sensation, then "parks" it between their cheek and gum to allow absorption.
Lozenges: Similar to gum, lozenges dissolve slowly in the mouth to deliver nicotine. They are often preferred for their discretion.

Prescription NRTs:

Inhaler: Resembles a cigarette and delivers a nicotine vapor that is absorbed in the mouth and throat.
Nasal Spray: Delivers nicotine quickly through the nose, providing fast relief from cravings.

Combination NRT therapy, using a long-acting form like the patch with a short-acting form like gum or lozenges for breakthrough cravings, is often more effective than using a single form alone.

Varenicline (Chantix)

Varenicline is a prescription medication that works by acting as a partial agonist at the $\alpha4\beta2$ nicotinic acetylcholine receptors in the brain. This means it has two effects: it provides a low level of stimulation to these receptors, reducing withdrawal symptoms and cravings, and it also blocks nicotine from attaching to the receptors, which diminishes the rewarding effects of smoking.

Common side effects include nausea, abnormal or vivid dreams, insomnia, and constipation. Some individuals may also experience mood changes or agitation.

Bupropion SR (Zyban)

Originally developed as an antidepressant, bupropion sustained-release (SR) was found to be effective in smoking cessation and is now also prescribed for this purpose. It works by increasing the levels of dopamine and norepinephrine in the brain, similar to the effect of nicotine, which helps reduce cravings and withdrawal symptoms.

Common side effects can include dry mouth, insomnia, headache, and agitation. Bupropion carries a seizure risk, and it is contraindicated for individuals with a history of seizures or those who have certain conditions like anorexia or bulimia nervosa.

Comparison of Smoking Cessation Medications


Feature	Nicotine Replacement Therapy (NRT)	Varenicline (Chantix)	Bupropion SR (Zyban)
Mechanism	Replaces nicotine from tobacco with clean nicotine.	Partial agonist at nicotinic receptors.	Inhibits reuptake of dopamine and norepinephrine.
Type	Patch, gum, lozenge, inhaler, nasal spray.	Oral pill.	Oral pill.
Prescription Status	OTC for patch, gum, lozenge; Prescription for inhaler, nasal spray.	Prescription only.	Prescription only.
Primary Effect	Relieves physical withdrawal and cravings.	Reduces cravings, withdrawal symptoms, and the pleasure from smoking.	Reduces cravings and withdrawal symptoms.
Common Side Effects	Skin irritation (patch), jaw soreness (gum), nausea, sleep problems.	Nausea, abnormal dreams, insomnia, constipation.	Insomnia, dry mouth, headache, agitation.
Seizure Risk	Very rare.	Rare.	Increased risk, especially at higher doses or in predisposed individuals.
Effectiveness vs. Placebo	Increases chances of quitting by 50-60%.	Increases chances of quitting by 100-140%.	Increases chances of quitting by 50-80%.

Combining Medications for Increased Success

For certain individuals, using more than one type of cessation medication at once can significantly increase their chances of quitting. Combining a long-acting NRT (like the patch) with a short-acting NRT (like gum or lozenges) is proven to be more effective than monotherapy. Some studies also suggest that combining varenicline with the nicotine patch may yield higher success rates than varenicline alone. However, combining oral prescription medications like varenicline and bupropion is not well-established, and should only be considered under the close supervision of a healthcare provider.

Conclusion: The Path to Quitting Tobacco

Successfully quitting tobacco is a complex process, but it is one that can be greatly aided by pharmacological support. By understanding that nicotine is the key addictive agent, individuals can better appreciate how medications like NRTs, varenicline, and bupropion address the physical symptoms of withdrawal and craving. The choice of medication depends on individual health factors, personal preference, and a healthcare provider's guidance. When combined with behavioral counseling and a robust support system, these pharmacological interventions offer a powerful and effective pathway to a tobacco-free life.

For more comprehensive resources on quitting smoking, visit the CDC's Quit Smoking page

Frequently Asked Questions

NRT is a medication designed to help you quit smoking by providing a controlled amount of nicotine without the other harmful chemicals found in tobacco. It helps manage withdrawal symptoms and cravings.

Varenicline, sold under the brand name Chantix, is a prescription pill that works by stimulating nicotine receptors in the brain to reduce cravings and withdrawal symptoms. It also blocks nicotine from reaching those same receptors, which reduces the enjoyment of smoking.

Yes, bupropion (brand name Zyban for smoking cessation) is an atypical antidepressant. It is also used to treat depression, and its effects on neurotransmitters like dopamine and norepinephrine help reduce cravings in people trying to quit smoking.

Yes, combining NRTs is often recommended for better results. Using a long-acting patch for continuous nicotine delivery can be paired with a short-acting product like gum or lozenges for relief during sudden, intense cravings.

Common side effects of varenicline include nausea, abnormal dreams, insomnia, and constipation. It's important to report any severe side effects or mood changes to a healthcare provider.

Individuals with a history of seizures should not take bupropion, as it can increase the risk. It is also contraindicated for those with anorexia or bulimia nervosa.

Studies have shown that using FDA-approved medications, especially when combined with behavioral support, significantly increases the chances of quitting successfully compared to quitting unassisted. Varenicline, for example, can more than double the chances of success over placebo.