Brief Answer:
Motivation to quit is the most important factor

Detailed Answer:
Hello Mr. XXXX,

Thanks for writing to us. I can understand your concern. I appreciate your decision to quit smoking.

Remember an important point that for any deaddiction motivation of the person to quit the substance is essential. Drugs are there to prevent withdrawal and smoothing the process of quitting.

You have tried almost all approaches (zyban, nicotine patch and gum).

In that case the best option is strict slow reduction of frequency of smoking with symptomatic treatment. You should reduce one cigarette every 4th day for that you have to increase the duration between two cigarette. You may get some withdrawal like constipation, uneasiness, restlessness, low mood and so on. These symptoms can be treated with propranolol, low dose benzodiazepines, multivitamins.

Regular follow up of treating doctor with motivational counseling is also important.

- Do you have any physical illness? Are you taking any medicines currently?

- Which t withdrawal symptoms do you feel whenever you attempt deaddiction?

- Do you have any stress in life?

I will be happy to help further after your response.

Regards,
Dr.Chintan Solanki.

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Brief Answer:
niclonz can be tried

Detailed Answer:
Hi,

Thanks for information. You are already on many medicines.

I again want to clarify that motivation is the main factor, you must try to control and that is why I have recommended very slow tapering. With this you can start Niclonz pastiles. It contains nicotin and is very useful for controlling craving. You should start 2 mg pastilles 2 hourly. More information and leaflet should be available with your psychiatrist.

You are willing to quit that is the most crucial factor and slow tapering with niclonz as substitute will surely give good results. For the best outcome I recommend 15 days indoor stay so you can receive symptomatic treatment as well as fast tapering is also possible.
Discuss these recommendations with your psychiatrist and go ahead.

I hope you will succeed. All the best.

Feel free to discus further.

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