Reviewed byRinat Zhumabekov, MDAddiction psychiatrist, experience 21 years · updated 8 Nov 2026
Key facts
- ICD-10 code
- F17.2
- Who provides care
- The clinic’s addiction doctor (narcologist) and psychotherapist
- Where
- Appointments at the clinic in Almaty, online consultation, home visits if needed
- Duration
- Acute cravings — 2–4 weeks; full support course — about 12 weeks
- Anonymity
- Consultations are anonymous, with no registry entry
- When it is urgent
- Chest pain, shortness of breath, or a child poisoned by nicotine liquid — call 103 or 112
- Outcome
- Quitting smoking and vaping, reduced cravings, and a relapse prevention plan
What you should know
Told by the on-call doctor of our mobile team. We are rarely called out at night for nicotine dependence — but we often see it on other calls. A person has just come off a drinking binge, is stabilized, and immediately asks to step out for a smoke. The mother of a teenager from the Bostandyk district calls during the day: “My son vapes twenty times an hour and wakes up at night to take a puff.” The dispatcher will note the age, what exactly is being used, for how many years, whether there have been attempts to quit, and whether there are heart or lung conditions.
Quitting nicotine does not require an emergency visit, so we usually start with an online consultation or an appointment at the clinic. But we also work at home if the person has limited mobility or is being treated for another addiction. To be honest, in winter in Almaty, when smog hangs over the lower part of the city, many smokers start complaining of coughing and shortness of breath — and that is exactly when they decide to quit. It is a good reason, and we help them do it without unnecessary suffering.
Signs of Nicotine Dependence
- the first cigarette or vape puff within half an hour of waking up
- smoking more often than planned, switching to stronger liquids
- irritability, anxiety, and difficulty concentrating without nicotine
- waking up at night to smoke, cravings that keep you from falling asleep
- continuing to smoke despite a cough or heart and lung disease
- failed attempts to quit, relapses under stress or with alcohol
- in teenagers, vaping as an essential part of socializing with peers
If two or three points apply, it is worth seeing a doctor. Phone advice is free and confidential. If life is at risk, call 103 or 112.
Why It Is So Hard to Give Up Nicotine
Nicotine reaches the brain quickly and triggers a release of dopamine, creating a sense of relief. The brain adapts, the number of nicotine receptors increases, and without the substance irritability, anxiety, and cravings appear. Smoking is reinforced by habits: coffee, a break at work, the commute in traffic. Vapes and electronic devices with nicotine salts can deliver high concentrations, and many users get more nicotine than they would from cigarettes.
The risk of dependence is higher in teenagers, since the developing brain is especially sensitive to nicotine. Contributing factors include smoking in the family, stress, depression, anxiety, alcohol, and dependence on other substances. The WHO regards tobacco dependence as a chronic disease and recommends a combination of counseling and medication support, and it does not consider e-cigarettes a safe alternative.
How the Consultation and Quit Program Work
The first meeting takes place online or at the clinic. The doctor assesses the degree of dependence, how long the person has smoked, coexisting illnesses, current medications, and past attempts to quit. Together we choose a quit date, usually 1–2 weeks ahead. If there are indications and no contraindications, the doctor selects medication support: nicotine replacement products or medications that reduce cravings — never self-prescribed. This is followed by short sessions with a psychotherapist every 1–2 weeks, more frequently in the first weeks.
Medication support is chosen with caution during pregnancy, in people with heart disease, epilepsy, or severe depression, and in teenagers — the decision is made by the doctor after an examination. Chest pain, sudden shortness of breath, or a child poisoned by nicotine liquid require a call to 103 or 112. A physical examination cannot be carried out online, so people with chronic illnesses need an in-person appointment.
How we help
Behavioral therapy
The psychotherapist helps identify the situations in which you feel the urge to smoke and prepare substitutes in advance: a walk, a glass of water, breathing exercises, a change of route. We teach how to cope with stress without a cigarette and ride out a wave of craving, which usually lasts only a few minutes. The method is recommended by the WHO and NICE as the foundation of quitting.
Medication support
When indicated, nicotine replacement therapy or medications that reduce cravings and the pleasure of smoking are used. The choice depends on the patient’s health, age, and preferences; regimens and doses are prescribed only by a doctor. Combined with counseling, medication support increases the chances of quitting. A course usually lasts up to 12 weeks.
Quitting vaping
Vapes with a high nicotine concentration often cause stronger dependence than people expect. The quit plan takes into account how often the person puffs and the strength of the liquid; sometimes a gradual reduction is used. With teenagers, we work together with their parents, without scare tactics or punishments, which usually only increase resistance.
Relapse prevention
The first three months are a high-risk period, especially with alcohol and stress. At Narcology 24, the patient receives an action plan for cravings and relapse, as well as short check-in calls or online sessions. A relapse does not mean failure: the doctor helps work out the cause and continue quitting. Support continues after the main course ends if the patient needs it.
Myths and facts
MythVaping is safe and helps you quit smoking
FactE-cigarettes contain nicotine and other substances, are not a safe alternative, and often sustain dependence. The WHO does not recommend them as a way to quit smoking.
MythYou must quit gradually, otherwise it is harmful
FactStopping nicotine abruptly is not life-threatening, and for many people it is easier than a drawn-out reduction. Unpleasant withdrawal symptoms are temporary, and medication support and counseling make them easier to bear.
MythIf you relapsed, it means you will never succeed
FactMost people need several attempts. Each attempt provides experience: it becomes clearer which situations are risky. With medical support, the chance of quitting successfully is much higher than when trying alone.
How a home visit works
- Call or message usThe dispatcher answers 24/7 and in 3–5 minutes checks the person's condition, age, how long the drinking or use has lasted, chronic conditions and the address. No surname needed.
- The doctor sets offAn addiction doctor or psychiatrist comes with equipment and medication. Travel time depends on the district — usually within an hour. If inpatient care or an ambulance is needed, we'll say so straight away.
- Examination and treatmentBlood pressure, pulse, oxygen saturation, blood sugar if needed and a neurological check. Then an IV drip or other treatment as indicated, 1–3 hours.
- A plan for the next daysAdvice for the family on what to do overnight and tomorrow, phone follow-up and a repeat visit if needed.
- Further treatmentCoding, psychotherapy, rehab or psychiatric follow-up — once the acute state has passed and the person is ready.
Prices in Almaty
| Initial addiction doctor consultation | 12 000 ₸ |
| Inpatient detox (per day) | 35 000 ₸ |
| Psychotherapy course (8 sessions) | 96 000 ₸ |
| Phone advice | free |
The final cost is agreed before treatment starts. Prices are in tenge and do not constitute a public offer.
Where to get help
“Nicotine and vaping addiction” in Almaty is available 24/7, including weekends. Home visits: all city districts and nearby settlements. For appointments, Narcology 24 has two branches: 84 Zhandosova St., Almaty and 21 Seyfullina Ave., office 11, Almaty. If you live elsewhere in Almaty and Almaty Region, call us and we'll advise the fastest way to get help.
Confidential and private
in Almaty our doctor can come in ordinary clothes in an unmarked car. Treatment documents are given only to the patient. If you need a certificate or sick note, this is discussed separately and only at your request.
Questions and answers
Do I need a doctor’s home visit to quit smoking?
Usually not: a consultation can conveniently be held online or at the clinic. A home visit makes sense if the person has limited mobility, is being treated with us for another addiction, or needs an in-person examination but cannot come to the clinic. Online consultations save travel time.
How quickly do cravings pass?
Acute withdrawal symptoms — irritability, anxiety, sleep problems — are most pronounced in the first 1–2 weeks and then ease. Individual bouts of craving may occur for several months, especially in familiar situations, but they become less frequent and shorter.
Can you help a teenager quit vaping?
Yes. The doctor and psychotherapist work with the teenager and the parents, taking age and individual needs into account. Medication support is prescribed to teenagers only under strict indications. If a teenager is in crisis, the 150 helpline for children and young people is available.
Will I gain weight if I quit smoking?
A small weight gain is possible, but it can be controlled through diet and physical activity. The benefits of quitting for the heart and lungs are far greater. The psychotherapist will help you avoid replacing cigarettes with food. This is discussed at the first session.
Can I quit smoking and drinking at the same time?
Yes, and it is often even helpful: alcohol is a common smoking trigger. But the decision is made individually, taking into account the severity of the alcohol dependence. Narcology 24 doctors will draw up a joint plan and decide on the order of the steps. Sometimes alcohol is treated first.
Is it anonymous?
Yes. Consultations are anonymous, with no registry entry and no information shared with third parties. Medical confidentiality is protected by the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System,” with exceptions only as provided for by law.
Where do doctors visit in Almaty and where are the branches?
Home visits cover all city districts and nearby settlements, 24/7. Appointments at two branches: 84 Zhandosova St., Almaty and 21 Seyfullina Ave., office 11, Almaty. Phone in Almaty: +7 (700) 309-29-88.
Sources and methodology
This page was prepared by the Narcology 24 medical editorial team based on:
- International Classification of Diseases ICD-10 and ICD-11, World Health Organization
- Clinical diagnosis and treatment protocols of the Ministry of Health of the Republic of Kazakhstan
- Code of the Republic of Kazakhstan “On Public Health and the Healthcare System”
- NICE (UK) guidelines on alcohol and drug misuse and mental health conditions
- WHO recommendations on the treatment of substance use disorders
This information is for reference only and does not replace a consultation with a specialist. Editorial policy
