How can my 64-year-old father quit a 40-year smoking habit?

Question

Hello doctor,

I am helping my 64-year-old father quit smoking after 40 years (he is currently at one pack per day). He has tried Nicotine patches and Varenicline in the past, but relapsed due to weight gain and mood swings. Please guide me about the following things;

Is there evidence for combining medications (such as Bupropion and Nicotine replacement) for higher success?
How do newer options like Cytisine compare?
What structured programs or CBT ( cognitive behavioral therapy) approaches have proven long-term success, especially for older adults with established habits?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Helping your 64-year-old father quit smoking after 40 years is a major but achievable goal, especially with a personalized approach.

So there is strong evidence that combining medications such as Bupropion (an atypical antidepressant) with Nicotine (a substance found in all tobacco products) replacement therapy (like patches or gum), which is more effective than using either alone, and this combination also helps reduce mood swings and post-cessation weight gain, both of which contributed to his past relapses.

Newer options like Cytisine, which is a plant-based partial nicotinic agonist, have shown comparable effectiveness to Varenicline (to treat smoking addiction) with fewer side effects and a well-tolerated alternative if available.

Apart from medications, structured behavioral programs like CBT (cognitive behavioral therapy) have proven particularly successful for older adults by targeting deeply ingrained habits and helping individuals reframe their thinking, manage triggers, and build healthier routines. Different programs that offer coaching or group support are effective when combined with medicines.

Ultimately, pairing medication with regular behavioral support and follow-up is the best strategy to give him a strong chance at long-term success.

I hope this information helps you.

Feel free to ask further queries.

Thank you.