The most commonly used quit medication is nicotine replacement therapy (NRT), which is available in several forms. Patches, gum and lozenges are available without a prescription. Providers must prescribe inhaler, nasal spray and oral quit medications like Zyban® and Chantix®. Providers can decide if an office visit is necessary for a prescription or not.

NRT, including free patches, gum and lozenges, is available to adults 18+ and is recommended off-label with prescription for youth under 18 years old who are moderately or severely addicted to nicotine and motivated to quit.

 NEW  US Preventive Services Task Force (USPSTF) and the American Thoracic Society (ATS) joint guideline for the treatment of tobacco dependence in adults recommends:

Varenicline over a nicotine patch for adults when treatment is being initiated
Clinicians begin treatment with varenicline in tobacco-dependent adults who are not ready to discontinue tobacco use, rather than waiting until patients are ready to stop tobacco use

Read all seven recommendations here.


Combined prescribing of long-acting (patch) and faster-acting (gum or lozenge) nicotine replacement therapy is encouraged for greater likelihood of quitting.


Place on the skin. Ideal for long-lasting craving relief. Gradually releases nicotine into the bloodstream.


Chew to release nicotine. Helpful way to reduce cravings. Allows users to control their dosage.


Placed in the mouth like hard candy. Offers the same benefits of gum without chewing.

If you want to quit with nicotine patches and gum or lozenges, there are 3 options for how to get them, how much you get and what it costs:

1.Sign up with 802Quits and get up to 8 weeks of FREE patches PLUS gum or lozenges (or up to 16 weeks when using only patches, gum OR lozenges). Learn how to refer
2.If you have Medicaid and a prescription, you can receive unlimited preferred brands of nicotine patches and
If your patient has Medicaid and a prescription, they can receive at no cost:
• Unlimited preferred quit medications, including gum, patches and Nicorette® lozenges
• Up to 16 weeks of non-preferred patches AND gum or lozenges, including Nicoderm® patch, Nicorette® gum, nicotine lozenges, Nicotrol® inhaler and Nicotrol® nasal spray
3.If your patient has other medical insurance, they may have access to free or discounted NRT with a prescription.

Medicaid and BlueCross BlueShield of Vermont provide benefits for NRT to help those under 18 quit tobacco and vaping use. See your plan for specific coverage.

Check to see if your patients are eligible for free nicotine replacement therapy via 802Quits or their insurance. Review this chart with your patient on nicotine replacement therapy by program.


In addition to nicotine replacement therapy, varenicline and bupropion have demonstrated efficacy as tobacco cessation aids. The likelihood of a successful quit attempt is increased if counseling is provided along with medications.



Cartridge attached to a mouthpiece. Inhaling releases a specific amount of nicotine.


Pump bottle containing nicotine. Similar to an inhaler, the spray releases a specific amount of nicotine.


Can be helpful in reducing cravings and withdrawal symptoms, such as anxiety and irritability. May be used in combination with nicotine replacement therapy products like patches, gum and lozenges.


Reduces the severity of cravings and withdrawal symptoms—does not contain nicotine. Lessens sense of pleasure from tobacco. Should not be combined with other medications.

If you are on medication for depression and/or anxiety, consult your doctor.

Medicaid Benefits

In Vermont, Medicaid members qualify for tobacco cessation as a preventive service.

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