By now, most of us know the reasons to quit smoking. Nonetheless it remains a maddeningly difficult habit to quit. We find reasons to procrastinate – maybe next week or next month when we’re less busy. Sometimes all it takes to keep us in the “planning to quit” phase is an inconvenience like scheduling a doctor’s visit. And we even get discouraged by our own inaction.
That’s where Zero comes in. Zero offers a path to quit smoking via an easy online interface – no trips to a doctor’s office. The entire experience is online. Convenience, for many of us, might be just what we need in order to stop making excuses and quit once and for all.
Does Zero work? Is it a good alternative to traditional methods? We tested it and in this review we’ll share the pros, cons and all other details about this service, so you can decide if it’s right for you.
- Convenience – Zero is totally online, no in-person doctor’s visits necessary
- Affordable – Zero saves you money compared to traditional path to accessing care
- A prescription treatment path that’s three times more successful than quitting by yourself
- Non-prescription treatment option for those who don’t want a prescription.
- Doctors are high quality, background-checked and licensed to practice in the United States
- Privacy – your information is safe.
- Not yet covered by insurance (but in the works).
- Not available for those under age 21.
- Not available in every state.
Zero is a valuable service for smokers who want to quit. Zero provides a convenient method to get onto one of several paths proven to help many people quit. And it’s cheaper than the traditional route to getting a prescription. Zero doesn’t offer every effective approach to smoking cessation, and its treatments aren’t ideal or suitable for everyone, but for many people it’s a recommendable tool for quitting.
- Why you should trust us
- What is Zero and what service does it offer?
- Treatment option 1: Bupropion (generic Zyban)
- Treatment option 2: Nicotine gum
- Treatment option 3: Bupropion + nicotine gum
- Does it matter where I live?
- Zero pricing
- Is Zero a good value?
- How to get started with Zero
- Privacy and safety considerations
- What criteria do we use to evaluate online healthcare services?
Innerbody Research recently celebrated its 20-year anniversary. Over the past two decades, we have helped tens of millions of readers make more informed decisions about staying healthy and living healthier lifestyles.
This review, like all medical-related content on Innerbody Research, is thoroughly vetted by one or more members of our Medical Review Board for accuracy. Additionally, we extensively analyze each service we review. We evaluate the entire experience from signing up to receiving products in the mail and then offer unbiased, marketing-jargon-free analysis based on the latest scientific evidence and medical standards.
Smoking cigarettes is a toxic habit, gradually destroying basically every major organ in the body. Over 16 million Americans are living with a smoking-related disease. Worldwide, over 8 million people die every year because of smoking – and roughly one eighth of those casualties aren’t even smokers, but actually people who die from exposure to second-hand smoke.
Zero aims to remove a significant obstacle that can prevent us from getting the help we need: the inconvenience of facilitating a visit to a doctor and jumping through hoops to get a prescription, if needed. Most of us won’t even cross the street to get the cup of coffee we’d prefer, so imagine how many of us have held off on quitting smoking because we don’t have the time to make it to an appointment, or even the time to schedule one.
It also happens to be significantly more affordable than some of the other common paths to quitting.
Zero flattens out these wrinkles, leaving you with fewer excuses. It takes minutes to visit their site, set up an online consultation and answer a few questions. You can do it from the comfort of your home, right now. Sometime between 2-24 hours from that time, you’ll have a solidified action plan. There’s nothing stopping you. That’s the primary value of Zero, and it is a real value.
After consultation with a doctor, Zero offers a 12-week course of bupropion as one option to help you quit smoking. If needed, Zero could extend your course for an additional 12 weeks afterward.
Bupropion is a prescription drug created to function as an antidepressant – and to this day that’s its primary use – but successful applications of a drug can end up different than originally envisioned as well. In this case, bupropion has also proven quite effective as a supportive medication to quit smoking. It curbs the cravings and, in many people, reduces withdrawal symptoms.
By itself, bupropion has proven to increase people’s success rate significantly as they try to quit smoking (though it has slightly less of a positive impact than varenicline (Chantix®), which is more expensive and isn’t offered by Zero at this time).
Bupropion isn’t a sure thing – studies show that about twenty percent of people who try bupropion to quit smoking have successfully refrained from smoking after one year. But compare the 20% success rate of bupropion to the 5% success rate of people trying to quit on their own.
Bupropion isn’t suitable for everyone and requires careful consideration; there are both common and uncommon side effects, as well as contraindications and potential drug interactions. Your consulting Zero doctor will review your medical history in order to determine if you are a candidate for taking bupropion.
You must be completely honest in your consultation with Zero doctors, and should also inform the office of your primary healthcare provider, if you intend to take bupropion.
The most common side effects of bupropion include:
- Agitation and irritability
- Dry mouth
Serious side effects may include:
- Suicidal thinking
At any time during the 12-week course of bupropion, you can reach out through your account interface (on either the app or the website) and ask any questions or share any concerns with a Zero doctor. The interface is very user-friendly.
The nicotine gum from Zero is available in either 2mg or 4mg dosage as a nicotine replacement therapy (NRT). (Zero recommends the 4mg strength if you are a smoker who smokes your first cigarette within a half hour of waking up.) There are multiple benefits of using a nicotine gum while you try to quit smoking:
- Withdrawal symptoms are unpleasant. People who quit cold turkey often get really discouraged by feelings of irritability, anxiety and just general restlessness. It can affect personal happiness and also relationships with others. Nicotine gum reduces these withdrawal symptoms significantly, letting you continue to focus on your everyday life.
- News flash: Smoking is highly addictive. It’s addictive partly because nicotine is an addictive substance. Replacing smoking with nicotine gum reduces cravings because you are still giving yourself nicotine – just not with all of the smoke inhalation. Over time, you can gradually wean off of the nicotine.
- Form new associations and reinforce new habits. You can use the nicotine gum as a way to reinforce new positive habits and behaviors. This severs the nicotine addiction from the act of smoking and can be a powerful mechanism helping people ditch the smoking habit for good.
When taken as instructed, nicotine gum is safe and increases the probability of success by about 55%. It’s very important not to exceed the amount instructed.
There are few possible side effects, including:
- Irritation in the mouth
Because one of the more common side effects of bupropion – agitation/irritability – also happens to be a common nicotine withdrawal symptom when people quit smoking, we believe many people will have greater success with Zero’s bupropion + gum treatment option than with bupropion alone. That way, if you experience unusual irritability during treatment, you’ll know it’s due to the bupropion and can consult accordingly with a doctor.
This combination path won’t be for everyone – not to be repetitive, but it’s because bupropion is contraindicated in some situations and interacts with some other prescription drugs. For those who can tolerate bupropion, though, the combo treatment from Zero increases your chances of responding well to treatment, making it a more powerful and effective path to quitting than either of the two treatments alone.
As with the bupropion-alone course, this lasts 12 weeks and requires a virtual visit with a Zero doctor prior to prescribing bupropion. And at any time, your account interface via the app or website lets you share your questions or concerns at any time with a Zero doctor.
Unfortunately, yes, not everyone in the United States can use all of Zero’s smoking cessation services.
The good news: their Nicotine gum is available in all 50 states.
The bad news: Zero’s bupropion isn’t going to be accessible everywhere. It is available in Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.
- Bupropion: First month is $18, and then $45/month afterward. There is a $15 fee for the virtual doctor’s visit, but if Zero’s doctor determines that bupropion isn’t suitable for you, your $15 is refunded.
- Nicotine gum: First month is $30, and then $42/month afterward.
- Bupropion + gum: $60 for the first month, and then $87/month afterward. Again, there is a $15 fee for the virtual doctor’s time at the outset, but that fee is refunded if the Zero doctor determines you should not be prescribed bupropion.
Logistics of insurance and shipping
Insurance doesn’t cover Zero yet, but Zero is working on this so stay tuned.
If you opt for one of Zero’s two prescription plans, the easiest thing to do is to take advantage of the Ro Pharmacy Network via Zero. This gets you free 2-day delivery of your shipment.
Knowing how hazardous it is to keep smoking, we would say yes absolutely, Zero is a good value. Compare it to the cost of continuing a smoking habit, which on average is a little over $2000 per year (excluding the medical bills that many smokers end up paying due to health problems). Zero’s most expensive plan costs only half as much as that. This means, if you’re an average smoker, quitting with Zero can save you more than $1000 this year, and over $2000 per year afterward.
The cost of Zero compares favorably to other treatment paths as well. If it works for you, then you have bypassed the added cost of therapy, which can make other treatment paths more expensive (though it can also yield a higher success rate). Zero doesn’t offer therapy at this time. Zero also doesn’t offer Chantix®, another prescription (like Bupropion) that helps people quit smoking. But Chantix® tends to cost people $100-$500 per month.
There’s one path that seems much cheaper at first, of course: the infamous Cold Turkey method. We all tend to try it at some point. The big problem with this method is that its success rate is so low… about 95% of people who try to quit cold turkey end up smoking again.
Zero doesn’t offer all of the treatment paths that have been successful in helping people quit smoking. But Zero does offer a few proven paths and makes these paths more affordable and convenient for you to try. That’s a good thing.
Getting started is easy. Here’s how it works.
Decide it’s time for you to quit. Hopefully you’ve already done this step.
Go to Zero’s website or app. You can use either your personal computer or smartphone.
Answer the doctor’s questionnaire. This virtual doctor’s visit is important for sharing important information about your health and medical history. You will also need to take and share a photo of yourself and your ID. Our testers found it very easy with either a smartphone or a personal computer. Note: in some states you’ll need to have a quick video chat with the consulting doctor, either via smartphone or using your computer’s webcam.
Decide if you’re open to a prescription. During this process, you’ll also share whether you are open to the possibility of taking prescription bupropion, if the doctor determines that would be a wise component and result in the best path for your success. If you indicate that you’re open to this possibility, then Zero’s doctor will review and determine the best treatment plan for you.
Wait a short time while the doctor reviews your history. If you finish this brief visit with enough time remaining during business hours, the whole process of Zero’s doctor reviewing your medical history is finished within a couple hours. That was certainly the case for our testers as well. If not during business hours, however, you will have the doctor’s feedback within 24 hours.
With your treatment plan determined, set a date 1-2 weeks into the future. This is the day you will begin to quit! Your shipment will arrive, 2-day free shipping. If your recommended Zero treatment plan involves bupropion, you’ll want to begin the treatment as instructed either 1 or 2 weeks before you quit smoking.
On your quit date, stop smoking! Your healthier life has begun.
Zero takes your health safety very seriously. It’s always important to tell your primary care provider about your plans to use bupropion via Zero, if that is what you end up doing. Your online consultation with a Zero doctor doesn’t replace your primary care provider relationship.
One cool thing: if you reach out to the medical support team at Zero, they’ll share all the important information with your healthcare provider’s office, to keep them fully in the loop. Our testers appreciated this level of service.
Here’s something else very important: your honesty during the online questionnaire and doctor consultation with Zero! If you answer any questions untruthfully, you could be jeopardizing your health – bupropion isn’t suitable for everyone. There are possible side effects and contraindications, so be honest and forthcoming with medical information.
Zero protects your privacy, so there’s no reason not to disclose everything and be fully honest. Zero adheres to strict privacy laws surrounding healthcare information. Your information is safe.
We customize our evaluation criteria depending on the type and nature of the health-related (telemedicine) service. For most online health services, we have five areas that we use for our evaluations, including:
Quality: Are the doctors on the service licensed to practice in the US? Are the physicians board certified in the relevant practice areas? Do they have a high quality medical review board with oversight? Are their treatment options FDA approved?
Value: Are you getting your money’s worth? Are there any hidden costs or charges? Does the provider offer discounts or free services to our readers?
Customer Support: How well does the healthcare provider help you choose the best treatment? How clearly are the options presented? How well does the healthcare company help you understand options and get treatment if necessary?
Privacy: Are all treatments sent in discreet packaging? Will your data be stored securely? Could your data ever be shared without your permission?
Speed: How fast will you receive your treatment from the moment you click “buy?” Are doctors and medical professionals responsive to your questions and needs when you are messaging them? Are the waiting times stated by the telemedicine provider accurate and consistent?