Nicotine Replacement Therapy

NRT (nicotine replacement therapy) is a type of smoking cessation treatment that uses special products to give small, steady doses of nicotine to help stop cravings and relieve withdrawal symptoms that occur when a person is trying to quit smoking.1

Quit Smoking Nicotine Products

NRT products are generally available over-the-counter in the US, in the UK and the rest of Europe. Popular brands include Habitrol, NiQuitin, Commit, Nicorette and Nicotinell.

Nicotine Gum

The pieces of gum are usually available in various flavours including fruit, liquorice and mint. Each piece typically contains 2 or 4 mg of nicotine, roughly the nicotine content of 1 or 2 cigarettes. The 4mg strength is the recommended strength for those smoking more than 20 cigarettes a day.

Users are directed to chew the gum until it softens and produces a tingling sensation or "peppery" taste. The gum is then "parked," or tucked, in between the cheek and gums. When the tingling ends the gum is chewed again until it returns, and is then re-parked in a new location. These steps are repeated until the gum is depleted of nicotine (about 30 minutes) or until the craving dissipates.

Nicotine Inhalers

Inhalers (or inhalators) consist of a plastic mouthpiece into which a replaceable cartridge is inserted. Users are directed to hold the inhalator like a cigarette and inhale through the mouthpiece to intake nicotine and relieve withdrawal sypmtoms, cravings and urges to smoke.

Nicotine Lozenges

Nicotine lozenges are dissoluble tablets that release therapeutic doses of nicotine when placed into the mouth and allowed to dissolve. They should not be chewed or swallowed whole. Users are typically directed place a lozenge in the mouth and allow it to dissolve while perioidically alternating placement to each side of the mouth.

Sublingual Tablet

Sublingual simply means dissolves under the tongue. These products work in a similar fashion to lozenges but are placed under the tongue. They should not be chewed or swallowed whole but placed in the mouth beneath the tongue and allowed to dissolve.

Nicotine Nasal Spray

A nicotine-containing liquid that the users self-administer through the nose. Users are directed to insert the spray tip into one nostril, pointing the top towards the back of the nose before pressing firmly and quickly. Maximum recommended dosage for adults: 64 sprays per daily (Nicorette Nasal Spray).

Nicotine Patch

Patches work using a trasdermal system which basically means that nicotine is released slowly into the body through the skin. When they are applied, nicotine passes through your skin and into the body, replacing nicotine that would normally be obtained from smoking. As the body adjusts to not smoking the size of the patch (or strength depending on brand) is gradually reduced over a period of up to 12 weeks or until they are no longer needed.

Free Nicotine Replacement Therapy

In the UK, those who are on low incomes or otherwise entititled to free health prescriptions may be able to obtain NRT treatments without any cost to themselves. Ask your GP in the first instance. Most likely you will be required to subscribe to a quit smoking program but it is generally agreed by both product manufacturers and NHS professionals that your chances of quitting long term are greatly improved with additional support above and beyond the use of nicotine replacement therapy alone.

Side effects

Nicotine replacement therapy side effects are generally similar to nicotine withdrawal symptoms or additionally through "overdosing" on a particular NRT treatment.

Side effects that are common to nicotine withdrawal symptoms include dizziness, headache, irritability, sleep disturbances, and depression. Patch users may experience skin irritation at the site of the patch or allergic reactions to the materials or adhesives on the patch.

To avoid the side effects of overdosing users shoould take care to read all enclosed instructions carefully to be aware of what they are and ensure that the approriate dosages are being consumed.

If you have a story to tell about the side effects of nicotine replacement therapy that you would like to share and perhaps save someone else the same fate, then we would like to hear it.

References

1. National Cancer Institute. NCI Dictionary of Cancer Terms. July 2009. Available at http://www.cancer.gov/Templates/db_alpha.aspx?CdrID=439409 (accessed on 25 July 2009).

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