Stopping smoking: varenicline (Champix), nicotine replacement, support

Why get support to stop smoking?

Quitting on your own is often hard, because nicotine dependence is both physical and behavioural. The Belgian practice guideline “Stopping smoking” (WOREL, updated in 2026) recommends that any medicine be part of a broader quit plan, combined with support.

For patients registered at Maison Médicale Parc Astrid, general practice consultations are covered by the INAMI flat-rate system: there is no payment per consultation for your GP's follow-up.

First consultation: taking stock

Your GP assesses your dependence (for example with the Fagerström test), your motivation, previous quit attempts and your health (COPD, anxiety, cardiovascular history, pregnancy), and together you set a quit date. The Belgian guideline regards nicotine replacement and stop-smoking medicines as equivalent options:

• Nicotine replacement therapy: a patch combined with a fast-acting form (gum, lozenge, spray) for sudden cravings; two forms together work better than one.
• Varenicline: first choice in the Belgian guideline when a medicine is chosen (weak recommendation); more effective than bupropion or a single form of nicotine replacement.
• Bupropion or cytisine: other prescription options, depending on your profile. Cytisine appears to be about as effective as varenicline, but was not reimbursed at the end of 2025.

Varenicline in practice

Withdrawn from the market in 2021 (nitrosamine-type impurities), varenicline (Champix) has been available again in Belgium since June 2025. You start it 1 to 2 weeks before your quit date, while still smoking: 0.5 mg once daily for 3 days, then 0.5 mg twice daily for 4 days, then 1 mg twice daily. Treatment lasts 12 weeks and may be extended by 12 weeks to help prevent relapse.

It roughly doubles the chance of lasting abstinence (at least six months) compared with placebo. INAMI reimburses it under conditions: adult patient, combined with behavioural support, prior authorisation from the health insurance fund's medical adviser, and no more than three attempts over five years.

Common side effects: nausea (usually mild), unusual dreams, sleep problems, headache; the dose can be reduced if needed. Report any change in mood or behaviour straight away. Caution is needed with a psychiatric or cardiovascular history; varenicline can also enhance the effects of alcohol.

Support: a pillar of quitting

Behavioural support helps you identify your triggers (coffee, alcohol, stress, the car), prepare replacement strategies and cope with withdrawal. According to Vivalis, the competent Brussels administration, support from a tobacco specialist (tabacologue) can triple your chances of quitting.

In Brussels, stop-smoking consultations with a doctor or a recognised tobacco specialist qualify for a partial refund: €30 for the first session and €20 for each of the next seven, i.e. 8 sessions every two years (specific conditions apply to pregnant women). The refund goes through your Brussels health insurance fund (mutualité): check with them. The Tabacstop helpline (0800 111 00) can also advise you, and your GP can refer you to a psychologist if stress or anxiety weighs heavily on you.

What about e-cigarettes?

According to the Belgian Superior Health Council (2022), e-cigarettes are less harmful than conventional cigarettes but not without risk: they only bring a health benefit if you stop tobacco completely, ideally followed by gradually cutting down on vaping. The 2026 Belgian practice guideline does not recommend them routinely and reserves them for specific situations. They are not advised for non-smokers, young people or during pregnancy.

The benefits of quitting

According to the World Health Organization, the benefits start very quickly:

• after 20 minutes, heart rate and blood pressure drop;
• after 12 hours, the carbon monoxide level in the blood returns to normal;
• between 2 and 12 weeks, circulation improves and lung function increases;
• between 1 and 9 months, coughing and shortness of breath decrease;
• after 1 year, the risk of coronary heart disease is about half that of a smoker;
• after 10 years, the risk of lung cancer is about half that of a smoker.

Quitting also saves money: to estimate how much, multiply the price of your pack by the number of packs you smoke per day, then by 365.

At Maison Médicale Parc Astrid, this follow-up is available in French, Dutch, English and Turkish (meet our team). Ready to start? Contact us to book a dedicated consultation or, if you are not yet registered, see our new patient page.

Sources

• BCFI/CBIP – Belgian Drug Compendium 10.5.2: treatment of nicotine dependence (2026)
• BCFI/CBIP – Folia: varenicline (Champix) back on the market (2025)
• Cochrane – Nicotine receptor partial agonists for smoking cessation (2023)
• Vivalis – Stop-smoking support from a doctor or tobacco specialist (accessed 2026)
• Belgian Superior Health Council – Vaping preferable to smoking, but not without risk (2022)
• WHO – Health benefits of smoking cessation (2020)