Three PBS-funded pharmacotherapies — nicotine replacement (NRT), varenicline (Champix) and bupropion (Zyban). All are Authority Required (Streamlined) and all require the patient to be enrolled in a support program (e.g. Quitline 13 78 48) with a stated quit date. Pharmacotherapy plus brief GP advice plus Quitline gives the best quit rates.
1PBS authority — what's required
✓Support program enrolled — Quitline (13 78 48) or in-clinic/other comprehensive counselling support — required for all three agents.
✓Quit date set — Patient has stated an intention to quit and set a quit date.
✓Annual quantity limits — NRT: 12 weeks per course, max 2 courses/year. Varenicline: up to 24 weeks/year. Bupropion: up to 9 weeks/year.
✓Authority type — Streamlined for all three — no prior approval call needed if criteria are met; confirm current codes at pbs.gov.au.
2Which agent
| Agent | Efficacy / PBS duration | Key caution |
|---|
| NRT (patch + PRN) | First-line; combination NRT (patch + gum/lozenge/spray) more effective than patch alone. 12 wk/course, max 2/year | Generally safe in cardiovascular disease |
| Varenicline (Champix) | Often the most effective single agent. Up to 24 wk/year | Now considered safe in stable mental illness (EAGLES, 2016); had a nitrosamine-related supply disruption in recent years — check current pharmacy stock |
| Bupropion (Zyban) | Roughly similar to NRT monotherapy. Up to 9 wk/year | Lowers seizure threshold — avoid in seizure disorder or eating disorder; caution with recent MI/unstable angina |
Verify at PBS — Combination NRT (patch + PRN gum/lozenge/spray) is often under-used and more effective than monotherapy — patches can start 1–2 weeks before the quit date. Nicotine vaping products are not PBS-subsidised — they sit on a separate TGA prescription (or pharmacist-only under 20 mg/mL) pathway, not this Authority framework.
3Safety & exclusions
Safety
- Bupropion: absolute contraindication in seizure disorder or eating disorder — both raise seizure risk.
- Bupropion + MAOI within 14 days — serotonin syndrome risk.
- Pregnancy: NRT preferred if quitting otherwise fails; avoid varenicline and bupropion.
Check / exclude
- Cardiovascular disease: NRT and varenicline generally safe; avoid bupropion if recent MI or unstable angina.
- Confirm current PBS Streamlined codes and quantity limits at pbs.gov.au before prescribing.
- Vaping is not PBS-funded and not first-line — consider only if other PBS options have failed, via the separate TGA pathway.
EN-09 v1.0 · Reviewed Jun 2026 · Review Dec 2026
For health-professional use. Eligibility and authority requirements summarised from public PBS reporting — confirm exact wording at pbs.gov.au. Covers NRT, varenicline and bupropion — not a complete dose-and-criteria matrix.
