Reviewed byRinat Zhumabekov, MDAddiction psychiatrist, experience 21 years · updated 8 Nov 2026
Key facts
- ICD-10 code
- F17
- Who provides care
- An addiction medicine doctor; a psychotherapist for behavioral support and work with the family
- Where
- Appointments at the clinic in Astana and online consultations; for teenagers, with parents taking part
- Duration
- Active program: 8–12 weeks; support continues for up to 6–12 months
- Confidentiality
- Medical confidentiality, treatment with no registry and no sharing of data
- When it’s urgent
- Chest pain, shortness of breath, coughing up blood, or a child suspected of being poisoned by vape liquid — call 103/112
- Outcome
- Quitting nicotine, controlling cravings, better breathing and sleep, and a relapse prevention plan
What you should know
This section is for those who are worried about a loved one who smokes: a teenager hiding a vape up their sleeve, a father who has smoked for decades and coughs every morning, a pregnant daughter who can’t quit. Nicotine is no less addictive than many illegal substances, and vapes with nicotine salts can create dependence very quickly. The good news: quitting smoking is one of the most thoroughly researched areas of medicine, and with a doctor’s support the chances of success are significantly higher.
Many families in Astana are dealing with vaping among teenagers, who buy vapes through acquaintances or online. Winter here is long, with frost and wind, and smokers switch to vapes and heated tobacco so they “don’t have to go outside” — and use becomes almost constant. It is important for parents not to stage raids but to preserve trust and offer real help. We consult relatives and smokers themselves both in person and online.
Signs of nicotine addiction and vaping that families notice
- a sweet, fruity smell; devices that look like flash drives or markers
- reaches for a cigarette or vape within the first few minutes after waking up
- irritability, anxiety, and trouble concentrating without nicotine
- puffing almost nonstop — at home, in the car, in the bathroom, even at night
- a morning cough, frequent colds, shortness of breath when climbing stairs
- failed attempts to quit, relapses under stress or in company
- a teenager spends pocket money on cartridges and hides the devices
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’s so hard to quit smoking and vaping
Nicotine reaches the brain within seconds and stimulates the release of dopamine, creating a quick sense of relief. The brain adapts, and without nicotine the person experiences irritability, anxiety, cravings, and disrupted sleep and concentration. Vapes with nicotine salts deliver high concentrations smoothly, without irritating the throat, so people — especially teenagers — take puffs far more often and become addicted faster than with ordinary cigarettes.
Beyond physiology, smoking is tied to habits: a break at work, coffee, a drive, stress, company. The risk is higher among teenagers, people with anxiety, depression, or ADHD, and children of parents who smoke. The WHO emphasizes that a combination of behavioral support and medication helps people quit — this way the chances are much higher than when trying to quit “on willpower alone.”
How the nicotine quit program works
You can start with a video consultation for relatives or for the smoker themselves. The doctor assesses the degree of dependence (years of smoking, amount, time of the first puff of the day, previous attempts to quit), any medical conditions, and motivation. This is followed by an appointment at the clinic in Astana or continued work online: a quit date is chosen, medication support is selected by drug class, and a plan for replacing smoking rituals is drawn up. Weekly contact helps the person get through the first, hardest weeks.
Medication support is chosen only by a doctor after an assessment: during pregnancy or breastfeeding, and with serious heart disease, epilepsy, or mental health conditions, the options are limited. Teenagers are prescribed medication with particular caution. Chest pain, severe shortness of breath, or coughing up blood are reasons to call 103 or 112. Online sessions are convenient for follow-up, but for people with lung or heart disease the first examination is better done in person.
How we help
Behavioral support
The doctor and psychotherapist help identify situations in which the hand reaches for a cigarette or vape and prepare a replacement in advance: a walk, a glass of water, breathing exercises, a change of ritual. We work with the anxiety and stress that often lie behind smoking. According to the WHO, regular sessions during the first weeks significantly increase the likelihood of success.
Medication therapy
For pronounced dependence, the doctor may prescribe nicotine replacement therapy or other medications that reduce cravings and withdrawal symptoms. The specific product is chosen after assessing the person’s health and contraindications — never self-prescribed. Combining medication with behavioral support is the standard of international guidelines, including NICE.
Program for teenagers
We work with teenagers gently and with parents involved. The doctor explains how nicotine affects the developing brain and helps the teenager find their own reasons to quit, rather than just complying with adults’ demands. We give parents recommendations: how to talk without threats, how not to create a “forbidden fruit,” and how to offer support after a slip.
Relapse prevention
A relapse in the first months is common, not a failure. We teach people to plan ahead for difficult situations: holidays, business trips, stress at work. If a relapse happens, it’s important not to drop the program but to look at what caused it and keep going. Online maintenance sessions help preserve the results achieved over the long term.
Myths and facts
MythVaping is safer, so it isn’t an addiction
FactVapes contain nicotine, often in high concentrations, and are no less addictive than cigarettes. They are especially risky for teenagers: nicotine affects the developing brain, attention, and anxiety levels.
MythYou have to quit cold turkey, otherwise it won’t work
FactThere is no single right way. Some people do well quitting abruptly on a chosen date; others do better with gradual reduction and medication support. What matters is that the plan is chosen with a doctor and includes behavioral help.
MythQuitting will inevitably make you gain a lot of weight
FactSome weight gain is possible, but it is manageable: a sensible eating routine, physical activity, and support. The benefits of quitting nicotine for the heart, blood vessels, and lungs far outweigh the risk of a few extra pounds.
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 Astana
| 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
In astana you can get help at home, at one of our two branches (6 Auezova St., office 37, Astana, 176 Imanova St., Astana) or online if you need a consultation rather than a procedure. The dispatcher answers 24/7 and will tell you straight away which option is safest.
Confidential and private
Information about your request, diagnosis and treatment is protected by medical confidentiality under the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System”. We do not share it with employers, schools, the police or neighbours; the only exceptions are those expressly set by law. A first name is enough to call us, and paid confidential treatment does not mean a registry entry.
Questions and answers
How do I talk to a teenager about vaping?
Start with curiosity, not accusations: ask what they like about vaping and what worries them about it. Share facts about nicotine without scare tactics. Agree on rules and offer the support of a specialist. Preserving trust is key: if the child is afraid of punishment, they will hide their vaping rather than quit.
Can I quit smoking with online consultations?
Yes, most of the program — the assessment, choosing a quit date, support in the first weeks — works well over video. This is convenient with a packed work schedule. An in-person appointment is recommended for people with heart or lung disease, during pregnancy, and for choosing medication when tests are needed.
Do “coding” and “one-session” treatments work?
There is insufficient scientific evidence that “coding” (a method widely used in Kazakhstan and CIS countries) or other “one-time” methods are effective for nicotine addiction. Narcology 24 uses approaches recommended by the WHO and NICE: behavioral support and medication therapy. They deliver real, honest results without promising “quit forever in one session.”
What should I do if a child has swallowed vape liquid?
Nicotine-containing liquids are toxic to children. If a child has swallowed the liquid and is vomiting, weak, having seizures, or having trouble breathing, call 103 or 112 immediately. Store devices and cartridges out of children’s reach, just like medications.
How long does quitting nicotine take?
Acute withdrawal symptoms — irritability, cravings, sleep problems — are usually strongest during the first 1–2 weeks and gradually ease over a month. The active program lasts 8–12 weeks, but habits and situational cravings can persist longer, which is why support matters.
Will this be recorded anywhere?
No. Narcology 24 works anonymously, without registration on any registry, and all data is protected by medical confidentiality under the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System”. For teenagers, the legal rules on the involvement of legal guardians apply; we will explain them during the consultation.
Where do doctors visit in Astana and where are the branches?
Home visits cover all city districts and nearby settlements, 24/7. Appointments at two branches: 6 Auezova St., office 37, Astana and 176 Imanova St., Astana. Phone in Astana: +7 (700) 309-30-17.
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
