Nicotine Replacement Therapy
Nicotine Replacement Therapy (NRT) is essentially any method, other than cigarettes or chewing tobacco, of putting nicotine into your bloodstream at a controlled and gradually reducing rate. Options include nicotine patches (on a separate page here), nasal sprays, gum, lozenges and inhalers.
These other sources of Nicotine usually contain only around one half of the amount supplied by cigarettes, but ease the physical withdrawal symptoms by allowing you a more drawn-out period to stop smoking. They are most effective when used with other stop smoking aids, such as support from friends and family, lifestyle changes, hypnotherapy or acupuncture.
What is Nicotine Replacement Therapy?
Nicotine Replacement Therapy comes in a variety of different forms which we list here:
Nicotine Patches
The patches each contain a specified amount of nicotine and comes in various
strengths, usually 21mg, 14mg and 7mg. The nicotine is contained in a gel on
the adhesive side of the patch, that releases nicotine slowly into your
bloodstream.
Nicotine patches come under various brand names, including Nicotrol, NicoDerm and Habitrol. NicoDerm and Habitrol come in 24 hour versions, while the Nicotrol patch is to be taken off before bedtime.
Nicotine patches need not interrupt your lifestyle at all. They can be worn while showering, swimming or exercising. The patches are also skin-colored and flat, meaning that they can be worn out of the house, at dinner parties and in the workplace without anyone knowing. See our page on nicotine patches for more information.
Nicotine Nasal Sprays
Nasal spray is the fastest acting of all the NRT treatments, because the aerosolized nicotine is sprayed directly into the nostrils
and on to the sensitive nasal membranes. From here it is rapidly absorbed into the bloodstream.
You will need to administer the spray anywhere up to 5 times per hour, depending on how many cigarettes you normally smoke. The advantage of the spray is that it gives an immediate nicotine hit, however there have been higher rates of dependency with the spray than with other forms of NRT.
Initial side effects sometimes include irritation of the throat and nose, as you might expect. Some smokers also report watery eyes, sneezing and other symptoms similar to hay fever - basically your body is getting used to something new and it takes time. These symptoms usually pass within a week. Smokers normally switch to the spray for around 1-2 month before stopping completely or reducing the dosage gradually for a further 4-6 weeks.
Nicotine Gum
Nicotine gum contains a dose of nicotine that is released when the gum is chewed. Actually its not like normal chewing gum, because with
nicotine gum you chew for a minute then put the gum in the corner of your mouth. This way the nicotine is released into the bloodstream
though your cheek and gums, rather than going down into your stomach and giving you a stomach-ache.
Because the nicotine has to travel through your cheek and gums, nicotine chewing gum is much slower than a cigarette at giving you that nicotine hit. Its also slower than the nasal spray, but a little faster than the nicotine patches.
Side effects to the gum are minimal although you should as always make sure not to smoke cigarettes at the same time. Certain acidic beverages, like soft drinks, can reduce the effectiveness f the gum, so don't drink them for at least 20 minutes after you start chewing.
Nicotine Lozenges
Similar in their effect to the nicotine gum, lozenges are instead a hard candy. the idea is that you keep the
candy in your mouth for
as long as possible and let it fully dissolve. Typically smokers will use 8-10 of these lozenges per day. Remember not to bite into
the lozenge - similarly to when you over chew the gum, this releases too much nicotine into your stomach and can give
you a stomach-ache.
Some smokers like the lozenge because it is the most inconspicuous way to stop smoking. If you're embarrassed or simply want to quit without telling your colleagues, lozenges may be the way to go.
Nicotine Inhalers
Just like those asthma inhalers that you've seen, puffing on a nicotine inhaler releases a dose of nicotine into your lungs. These doses
are extremely low, in fact it takes around 80 doses to mimic one cigarette. The inhaler is used for a period of 3-6 months in total.
Some smokers like the inhaler because it replicates the puffing action of smoking and its something to do with their hands. Others however, dislike the attention that an inhaler can bring, especially in social situations where they would normally be smoking the most.
Side effects of the inhaler are minimal, but some may experience irritation of the throat or inside the mouth. This usually passes within a few days.
How does Nicotine Replacement Therapy help with smoking?
First of all, NRT should not be used by itself. For example, a recent study found that only 7% of smokers who used patches had managed to kick the habit 6 months later. However, when combined with other aids, such as support from friends and family, hypnotherapy or acupuncture, NRT is a very effective addition to your stop smoking plan.
There is a real danger that NRT will not be effective unless changes are made to your lifestyle too. While NRT will help with the nicotine cravings, you should avoid putting yourself in situations where habit or custom tells you that you need a cigarette. Don't follow your colleagues out for a cigarette break, no matter how much you need to get off your desk, and try to avoid late night parties for at least a while. Remember that alcohol will reduce your willpower like nothing else.
Are there any side effects of Nicotine Replacement Therapy?
Its very important that you give up smoking completely when you move on to NRT. Smoking while wearing a patch or using the inhaler effectively doubles your nicotine intake and can be very dangerous to your health. Always follow your doctor's advice.
Most patches are designed for 24 hour use. Smokers will occasionally find that this leads to nightmares or unusually realistic, and sometimes frightening, dreams. If these do not pass after a few days, there are other options such as 16 hour patches that should help.
Some users report that the patches cause some itching and slight swelling for around an hour after putting it on. For these reason its important to place the patch in a different spot each day.
There are a number of existing medical conditions that can be affected by Nicotine Replacement Therapy. These include allergies, heart conditions, or diseases of the liver and kidney. Pregnant mothers should avoid NRT in the same way as they would smoking. Be sure to give your doctor a complete medical history before asking for any form of NRT.