Adult Smoking Cessation Treatment (Tobacco Use Disorder)
Fast MD-only help to quit smoking by secure online video visit, $49 flat-fee, no insurance required.
Cigarette smoking and other tobacco use are leading preventable causes of heart disease, stroke, lung disease, and cancer. Quitting is difficult but achievable with the right support. Our board-certified MDs use guideline-based evaluation to review your smoking history, medical conditions, prior quit attempts, and preferences, then build an evidence-based quit plan with medications and behavioral strategies that fit your life.
- $49 flat-fee adult visit
- MD-only care (no mid-levels)
- No insurance required
- Secure video visits in 25+ states
Online MD-Only Smoking Cessation Care
- Adult-only evaluation of cigarette, cigar, and vaping use
- Assessment of nicotine dependence and readiness to quit
- Evidence-based meds such as varenicline, bupropion SR, and NRT when appropriate
- Clear criteria for when in-person cardiology or pulmonary follow-up is needed
Adults 18+ only. TeleDirectMD does not prescribe controlled substances or chronic opioids for withdrawal or anxiety and is not a detox program for other substances.
What Is Tobacco Use Disorder in Adults?
Tobacco use disorder is a chronic, relapsing condition in which nicotine from cigarettes, cigars, or other products leads to dependence. Many adults smoke within minutes of waking, struggle to cut down, and continue smoking despite known health risks. Nicotine changes brain pathways related to reward and stress, which is why quitting can cause withdrawal symptoms such as irritability, restlessness, and craving.
Stopping smoking lowers the risk of heart attack, stroke, lung disease, and many cancers, and it often improves energy, breathing, and finances. Multiple evidence-based tools exist, including nicotine replacement therapy, non-nicotine prescription medications, and structured behavioral support. Telehealth is well suited for helping adults choose a quit date, select medications, review safety, and build a realistic follow-up plan.
Symptoms, Risks, and Red Flags Related to Smoking
Most adults seeking help to quit smoking can be managed through a virtual visit. However, certain symptoms in people who smoke suggest urgent underlying heart, lung, or vascular disease that requires in-person or emergency care rather than a routine telehealth quit-plan visit.
| Symptom or history | What it suggests | Telehealth appropriate? | Red flag requiring urgent in-person care |
|---|---|---|---|
| Smoking cigarettes daily with morning cravings | Nicotine dependence and higher relapse risk | Yes, appropriate for telehealth-based quit planning | Not a red flag by itself |
| Multiple past quit attempts with relapse | Chronic tobacco use disorder that benefits from medication plus counseling | Yes, telehealth is suitable for new evidence-based strategies | Not a red flag alone |
| Chronic cough and shortness of breath on exertion | Possible COPD or other smoking-related lung disease | Telehealth can triage and encourage in-person lung evaluation | Sudden severe shortness of breath or chest pain |
| Chest pressure, jaw or arm pain with exertion | Possible coronary artery disease or angina | No for active symptoms | Requires urgent in-person or emergency cardiology evaluation |
| Coughing up blood | Possible lung infection, pulmonary embolism, or malignancy | No | Needs prompt in-person evaluation and imaging |
| Leg pain when walking that improves with rest | Possible peripheral arterial disease | Telehealth may help triage and encourage vascular workup | Sudden cold, pale, or numb limb requires urgent care |
| Severe depression, suicidal thoughts, or recent suicide attempt | High-risk mental health condition | No for standalone telehealth quit visit | Requires urgent in-person or crisis mental health evaluation |
| Heavy alcohol or other substance use with smoking | Co-occurring substance use disorders | Telehealth can offer limited support and referrals | Active intoxication, withdrawal, or safety concerns need in-person care |
| Pregnancy or planning pregnancy | Higher need to quit with attention to fetal safety | Telehealth can help with counseling and options discussion | Any pregnancy complications require obstetric follow-up |
Differential: Smoking vs Vaping vs Other Nicotine Use
Quitting cigarettes is the priority, but many adults also use vaping devices, smokeless tobacco, cigars, or nicotine pouches. During your TeleDirectMD visit, the MD will assess all nicotine sources, prior quit methods, and your medical history to tailor a plan that addresses overall dependence rather than only 1 product.
Daily Combustible Cigarette Use
- Highest risk for lung cancer, COPD, heart disease, and stroke
- Often strong morning cravings and withdrawal when cutting down
- Responds well to medications plus behavioral support
- Quit plan usually centers on a clear quit date and structured follow-up
Other Nicotine Patterns
- Vaping: May deliver high nicotine with fewer combustion toxins but still drives dependence; not considered risk-free.
- Smokeless tobacco: Linked to oral cancers, gum disease, and cardiovascular risk.
- Dual use: Combining vaping, cigarettes, or cigars often indicates higher dependence.
- Nicotine pouches or gum: Low-risk when used as part of a planned taper supervised by an MD.
Telehealth can help you weigh the pros and cons of different medications and nicotine replacement options and design a realistic stepwise plan to completely stop combustible tobacco rather than indefinitely substituting 1 product for another without a clear end point.
When Is a Video Visit Appropriate for Smoking Cessation?
When a Video Visit Is Appropriate
- Adult 18+ currently using cigarettes, cigars, or vaping products
- Medically stable without active chest pain, acute shortness of breath, or severe withdrawal
- Ready to quit now or within the next 30 days, or willing to cut down with a plan
- Interested in medications such as varenicline, bupropion SR, or nicotine replacement
- Comfortable reviewing mental health history and current medications by video
- Able to obtain prescriptions, over-the-counter products, and follow-up as advised
Red Flags Requiring In-Person or ER Care Before a Quit Plan
- Active chest pain, pressure, or shortness of breath at rest
- Coughing up blood, unexplained weight loss, or night sweats
- Severe depression, suicidal thoughts, or recent suicide attempt
- Confusion, severe agitation, or suspected intoxication or withdrawal
- Recent stroke, heart attack, or unstable heart rhythm without recent follow-up
- Pregnancy with concerning symptoms that have not been evaluated
If any red-flag symptoms are present, seek in-person or emergency care immediately. TeleDirectMD focuses on guideline-based quit planning and is not an emergency service or a substitute for in-person evaluation of acute heart, lung, or mental health problems.
Treatment Options for Adult Smoking Cessation
Stopping smoking is more effective when medications and behavioral strategies are combined. Our MDs follow evidence-based guidelines to help you choose an approach that matches your dependence level, medical history, and preferences.
Behavioral and Lifestyle Strategies
- Set a specific quit date and plan for what you will do instead of smoking at usual times.
- Identify triggers such as coffee, alcohol, driving, or stress and develop alternative responses.
- Remove cigarettes, lighters, and ashtrays from your home, car, and workplace when you start your plan.
- Ask supportive family or friends to help you stay accountable and avoid smoking around you.
- Use evidence-based quitline or text support programs in addition to your TeleDirectMD visit when available.
Medication Options (When Appropriate)
- Nicotine replacement therapy (patch, gum, lozenge) to reduce withdrawal while you break behavioral habits.
- Varenicline to partially stimulate nicotine receptors and reduce craving and satisfaction from cigarettes.
- Bupropion SR to support quitting and help with withdrawal, especially when depression is also present and benefits outweigh risks.
- Combination approaches such as nicotine patch plus short-acting gum or lozenge for breakthrough cravings.
TeleDirectMD carefully reviews your medical and mental health history, current medications, and cardiovascular risk before prescribing any stop-smoking medication. We do not prescribe controlled substances for tobacco withdrawal and will recommend in-person follow-up if you need more intensive mental health or substance use treatment.
Common Medications Used for Adult Smoking Cessation
The exact regimen is individualized based on your smoking pattern, prior quit attempts, medical conditions, and preferences. The table below shows typical examples your MD may consider. Not all options will be appropriate for every adult.
| Medication | Dose | Duration | When it is used |
|---|---|---|---|
| Varenicline 1 mg tablet (after titration) | Start 0.5 mg once daily for 3 days, then 0.5 mg 2 times daily for 4 days, then 1 mg 2 times daily | Typically 12 weeks, with option to extend if helpful and tolerated | Adults without major contraindications who want a first-line non-nicotine medication and can follow titration schedule |
| Bupropion SR 150 mg tablet | 150 mg once daily for 3 days, then 150 mg 2 times daily | Typically 7–12 weeks or longer with monitoring | Adults without seizure disorder or certain psychiatric or eating disorders who may benefit from mood and craving support |
| Nicotine patch 21 mg/24 hr | Apply 1 patch daily to clean, dry skin and rotate sites | Often 6–8 weeks at full dose with later taper | Adults who smoke about 10 or more cigarettes per day and prefer steady baseline nicotine support |
| Nicotine gum 2 mg or 4 mg | Chew and park 1 piece every 1–2 hours initially, up to labeled maximum | Weeks to months as part of a structured taper plan | Breakthrough cravings or situational smoking urges, often combined with a patch for baseline control |
| Nicotine lozenge 2 mg or 4 mg | Allow 1 lozenge to dissolve every 1–2 hours initially, up to labeled maximum | Weeks to months as part of a structured plan | Adults who prefer a discreet oral option instead of gum and can observe dosing limits |
These are example regimens only. Actual medications, doses, and durations are determined by the MD after reviewing your smoking history, medical and mental health conditions, and current medications. TeleDirectMD does not prescribe controlled substances for smoking cessation and will coordinate with in-person care when more intensive treatment is needed.
Home Care, Expectations, and Return to Work
Quitting smoking is a process, not a single event. Slip-ups and cravings are common, especially in the first days and weeks. The goal is to reduce cigarette use to zero and maintain that change long term, not to be perfect every day without support.
- Use medications and nicotine replacement exactly as prescribed, including the start date and taper schedule.
- Plan for high-risk times of day (such as first thing in the morning or during breaks) with specific alternatives.
- Limit alcohol and avoid other triggers that historically lead to smoking.
- View slips as a signal to adjust your plan rather than as a failure, and schedule follow-up if cravings are intense.
- Celebrate milestones such as 24 hours, 7 days, and 30 days smoke-free to reinforce progress.
Most adults can continue working while quitting, and many employers support smoke-free efforts. If a work note is needed, TeleDirectMD can generally provide documentation of evaluation and treatment rather than recommending time off, unless there are additional medical or mental health concerns.
TeleDirectMD Telehealth Disclaimer
TeleDirectMD provides MD-only virtual urgent care for adults using secure video visits to evaluate conditions like tobacco use disorder and smoking-related symptoms. Visits are $49 flat-fee with no insurance required and are available in 25+ states. Our physicians follow evidence-based guidelines, clarify what can be safely managed via telehealth, and explain when in-person primary care, cardiology, pulmonary, mental health, or emergency evaluation is more appropriate. TeleDirectMD is not an emergency service or a replacement for comprehensive in-person care.
Adult Smoking Cessation Treatment FAQs
Yes. For medically stable adults, telehealth is an effective way to start an evidence-based quit plan. During your visit, an MD reviews your smoking history, medical and mental health conditions, prior quit attempts, and preferences, then recommends medications and strategies that fit your situation. If we identify red-flag symptoms such as chest pain or severe shortness of breath, we will direct you to in-person or emergency care instead of managing it fully online.
Many guidelines support setting a clear quit date, but some adults do better with a structured cut-down plan that leads to a quit date. We will discuss both approaches and help you choose a path that feels realistic. Medications such as varenicline or nicotine replacement can be started while cutting down, with a target date to stop completely once you have built up new habits and support.
Depending on your history and preferences, we may recommend varenicline, bupropion SR, nicotine patches, short-acting nicotine gum or lozenges, or a combination such as patch plus gum. We will review potential benefits, risks, side effects, and interactions so that you understand why a particular option is being suggested and how to use it correctly for the best chance of success.
Yes. Bupropion is generally avoided in people with a history of seizures, certain eating disorders, or significant alcohol or sedative withdrawal risk. Varenicline may not be ideal for some adults with complex psychiatric histories or those who cannot safely report changes in mood or behavior. During your visit, we will carefully review your medical and mental health history to decide which options are appropriate and when in-person care is safer than telehealth-only prescribing.
Nicotine replacement therapy provides controlled, lower-risk nicotine without the thousands of toxic chemicals found in cigarette smoke. It is meant to be a temporary tool to reduce withdrawal while you break the behavior of smoking. When used as directed and tapered over time, NRT does not simply swap 1 addiction for another but helps you move toward completely nicotine-free living with a higher chance of success than willpower alone for many adults.
Slip-ups are common, especially in the first weeks. A single cigarette or even a brief relapse does not mean you have failed or that treatment is not working. The key is to restart your plan as soon as possible, review what triggered the slip, and adjust your strategies. Telehealth follow-up can help you problem-solve and reinforce progress instead of abandoning the quit attempt after a setback.
Vaping may reduce exposure to some combustion byproducts compared with cigarettes, but it still delivers nicotine and is not risk-free. TeleDirectMD focuses on FDA-approved medications and nicotine replacement rather than recommending vaping as a primary quit method. If you already vape, we can discuss how to move toward complete nicotine cessation instead of indefinitely switching from 1 product to another without a clear plan to stop altogether.
Many evidence-based regimens for varenicline or bupropion SR last at least 7–12 weeks, and some adults benefit from longer courses under medical supervision. Nicotine patches, gum, or lozenges are usually tapered over several weeks or months. The decision to taper is based on your craving pattern, relapse risk, and side effects. We will discuss a timeline and follow-up plan that balances benefit with the goal of eventually being medication-free when appropriate and safe for you.
Yes. Smoking affects nearly every organ system, and long-term follow-up with an in-person clinician is important for blood pressure, cholesterol, cancer screening, lung function, and other preventive care. TeleDirectMD is designed to complement, not replace, your local primary care team by providing convenient MD-only video visits focused on quitting, medication management, and clear guidance you can share with your in-person clinicians.
TeleDirectMD offers MD-only, guideline-based smoking cessation care through secure video visits with a simple $49 flat-fee model and no insurance required in 25+ states. We prioritize safe prescribing of varenicline, bupropion SR, and nicotine replacement, realistic planning around work and family life, and explicit red-flag education so you know when in-person cardiology, pulmonary, mental health, or emergency evaluation is safer than telehealth alone.