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Nicotine Replacement Therapy (NRT)Nicotine is the substance in cigarettes that is addictive. If you are trying to give up smoking, nicotine replacement therapy (NRT) can help you cope with nicotine withdrawal symptoms, and can double your chances of success.
NRT includes nicotine products, such as gum and patches, which work by getting nicotine into your system without the tar, carbon monoxide and other poisonous chemicals you get from tobacco smoke. So, while you are becoming a non-smoker, you can still get nicotine from NRT. Once you become comfortable not smoking, you can gradually cut out the NRT.
As well as chewing gum and patches, NRT is also available as lozenges (tablets that you put under your tongue), and as an inhaler, or nasal spray. Choose whichever suits you best after discussing your options with your GP or a smoking counsellor. It is very important not to smoke while you are using NRT.
For more details please refer to thiis patient handout that discusses the pros/cons of each type of nicotine replacement therapy to help you choose what will work best for you.
You can chew nicotine gum whenever you feel a craving. Nicotine is absorbed into the lining of your mouth. Nicotine gum is available in two strengths. For heavy smokers, a 4mg nicotine gum is available, and for lighter smokers, there is a weaker, 2mg gum. The taste can be unpleasant at first but for most people this only lasts about a week or so.
Before using nicotine gum, you should read the instructions carefully because it needs to be 'chewed' differently than normal gum.
Nicotine tablets, sometimes called microtabs, are placed under your tongue and dissolve quickly. Depending on how much you smoke, one or two tablets are taken every hour. However, you should not need to take them for more that six months.
Nicotine lozenges should be sucked slowly to release nicotine contained in them. They take about 20-30 minutes to dissolve and are available in two strengths - 2mg and 4 mg.
Nicotine inhalers look like a plastic cigarette. The inhaler has holder into which nicotine cartridges are fitted. When you draw on the inhaler, like a cigarette, it releases nicotine vapour which is absorbed into you mouth and throat.
Nicotine nasal spray works by passing nicotine through the lining of your nose. The nicotine in the spray is absorbed quicker than with the gum or the patch, but it can take a while to get used to, and can irritate your nose. You will need a GP's prescription for a nasal spray.
Nicotine patches are effective for many regular smokers, and can be worn all day (24 hour patches), or during the daytime (16 hour patches). Patches are available in different doses. If you smoke 10 cigarettes, or more, a day, you may consider starting with the higher dose. You should not use them for more than 12 weeks and you should gradually reduce the dose.
Although the once-a-day patch has largely supplanted the gum first used in nicotine replacement, for some, the most effective treatment could involve one or both.
The patch may be easier to use, but the gum is the only product that allows you control over blood nicotine level. Some people know they'll do better if they stay in control. And would-be quitters who do fine on the patch until they run into a stressful business meeting may stifle that urge to bum a cigarette if they boost their nicotine level in advance with a piece of gum.
When you are ready to quit smoking, you may want to use nicotine replacement therapy to help you give up cigarettes. The cost of nicotine replacement therapy is about the same or less than the cost of cigarettes.
The nicotine patch, gum, nasal spray and inhaler are all forms of nicotine replacement therapy. All forms of nicotine replacement can help lessen your urge to smoke. This means you have less craving for nicotine when you stop smoking. You may still feel a craving to smoke, but don't smoke while using the patch, gum, nasal spray or inhaler.
Who should use nicotine replacement therapy?
Almost every smoker can benefit from using nicotine replacement therapy. If you are pregnant or if you have heart or blood vessel problems, your doctor will be careful about giving you the nicotine patch or gum.
How do I know what strength is right for me?
Patch. Most smokers should start using a full-strength patch (15 to 22 mg of nicotine) every day for 4 weeks and then a weaker patch (5 to 14 mg of nicotine) for another 4 weeks.
Gum. Many smokers should start using the 2-mg dose. However, you may want to start with 4-mg gum if you:
If you are a very light smoker (less than 10 to 15 cigarettes a day) or have health problems, your doctor can help you select the right dose.
Should I use the nicotine patch, gum, nasal spray or inhaler?
Any of these treatments can help once you are ready to quit. The choice is up to you. Some people don't like the taste of the gum or don't like chewing in public. They prefer the patch. Other people have been unable to quit on the patch and want to try the gum. Some people prefer to use a nasal spray and some prefer the inhaler. Using the nicotine patch, gum, nasal spray or inhaler almost doubles your chances of quitting. Here is some information to help you decide which one is right for you.
Directions for use: At the start of each day, place a new patch on a part of your body between the neck and the waist. Put the patch on a new spot each day to lessen skin irritation.
Treatment period: The patch is usually used for up to 8 weeks.
Side effects: Some people who use the patch get a rash on their body where the patch is placed. Skin rashes are usually mild and easily treated. Moving the patch to another area of the body helps.
If you have any side effects from the patch, be sure to tell your doctor right away.
How to get the patch: You can buy the patch without a doctor's prescription. To be safe, carefully read and follow the directions inside the package. You can talk to your doctor about how to use it and how long to use it.
Directions for use: The gum must be chewed in a special way to make it work. Chew it slowly until you notice a "peppery" taste. Then stop chewing and move the nicotine gum between your cheek and your gum. Each piece of nicotine gum should be kept in your mouth for about 30 minutes.
Treatment period: A regular schedule (at least one piece of nicotine gum every 1 to 2 hours for 1 to 3 months) may give the best results. Some people don't chew enough pieces of gum a day and or they don't chew the gum for 8 weeks. They might not get the most benefit from nicotine gum.
Side effects: Some people have mild side effects such as hiccups, upset stomach or sore jaws. Most of these side effects go away if the gum is used correctly.
If you have any side effects from the gum, be sure to tell your doctor right away.
How to get nicotine gum: You can buy the gum without a doctor's prescription. To be safe, carefully read and follow the directions inside the package. Also, you can talk to your doctor about how to use it and how long to use it.
Directions for use: Apply one spray in each nostril. Use the spray one to two times each hour while you are awake. Use the spray at least 8 times a day. Don't use it more than 40 times a day.
Side Effects: The nasal spray may cause nasal irritation, diarrhea and a fast heart rate. If you have hay fever or sinus infection, ask your doctor about using one of the other forms of nicotine replacement therapy.
If you have any side effects from the nasal spray, be sure to tell your doctor right away.
How to get the nasal spray: You can only get the nasal spray with a doctor's prescription. To be safe, carefully read and follow the directions inside the package.
Directions for use: Inhale from a cartridge when you have a desire for a cigarette. Use no more than 16 cartridges a day for up to 12 weeks.
Side Effects: You might have irritation of throat and mouth when you first start to use the inhaler. It might make you cough. You should get over this after a while.
If you have any side effects from the inhaler, be sure to tell your doctor right away.
How to get the inhaler: You can only get the inhaler with a doctor's prescription. To be safe, carefully read and follow directions inside the package.
Adapted from the Centers for Disease Control and Prevention handout, "You Can Quit Smoking," retrieved May 2001, from: http://www.cdc.gov/tobacco/quit/canquit.htm
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This information is not intended as individual medical advice and does not substitute for the knowledge and judgment of your health care professional. This information does not contain any assurances that this product / products is safe, effective, or appropriate for you.
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