NICOTINE REPLACEMENT THERAPY

NICOTINE REPLACEMENT THERAPY

What is Nicotine Replacement Therapy?

PATCH

LOZENGE

• Medically-approved methods to receive nicotine other than through tobacco
• Used to help quit smoking cigarettes
• Contain small doses of nicotine to fight cravings
• Doses of nicotine are gradually decreased until no longer needed

• nicotine is passed through the skin into the bloodstream
• available over the counter
• gradually switch to lower-dose patches
• FDA approved to be used for 3-5 months

• available over the counter
• nicotine absorbed through mucous membranes of mouth
• (like nicotine gum) available in 2 strengths: 2 mg & 4 mg
• dose chosen depending on how long after waking up the individual has his/her first cigarette

Side Effects

Recommendations

Application

Side Effects

nausea

heart burn

hiccups

headache

gas

trouble sleeping

use for 12 weeks:

1 lozenge every 2 hrs for first 6 weeks

1 every 2-4 hrs for weeks 7-9

1 every 4-8 hrs for weeks 10-12

do not eat/drink 15 min before use

suck on lozenge until fully dissolved (~20-30 min)

do not bite, chew, or swallow

do not use > 5 in 6 hours, or > 20 per day

do not use with other NRTs

• applied on skin preferably in the morning
• apply onto clean, dry, non-hairy surface of skin, below neck & above waist
• different forms of patches:
• 16 hour patch: for light/average smokers
• 24 hour patch: for heavier smokers; helps with early morning withdrawal

Skin irritation

Racing heart beat

Sleeping problems/unusual dreams

Headache

Nausea

Muscle aches & stiffness

Choosing a NRT method

Types of Nicotine Replacement Therapy

• Depends on your lifestyle & pattern of smoking
• Gums, lozenges, & inhalers—allow user to control dosage of nicotine to aid in keeping cravings under control
• Nasal spray—works quickly & fights cravings in the moment
• Inhalers—mimic cigarettes (puffing & holding the inhaler)
• Patches—convenient; only need to be applied 1x a day

GUM

5 methods approved by the FDA:

1. Patch (transdermal nicotine systems)

2. Gum (nicotine polacrilex)

3. Nasal spray

4. Inhalers

5. Lozenges

• Fast-acting
• Nicotine absorbed thru mucous membranes of mouth
• available over the counter
• comes in 2 & 4 mg strengths
• do not eat ~15 min before or during use
• max. 24 pieces of gum per day
• recommended use: 6-12 weeks
• best to use on a fixed schedule during the day

INHALER

Side Effects

• requires prescription
• thin plastic tubes with a nicotine cartridge inside
• When taking puff from inhaler, the cartridge puts out a pure nicotine vapor
• Delivers most of nicotine vapor to the mouth– absorbed into bloodstream
• Recommended dose: 4-20 cartridges per day (slowly tapering off over 6 months)

bad taste

jaw discomfort

increased heart rate

throat irritation

nausea

hiccups

mouth sores

potential dentures/dental damage

Risks

Side Effects

• keep away from small children & pets--even used cartridges contain harmful amounts of nicotine
• most expensive NRT

mouth/throat irritation

coughing

stomach pains

NASAL SPRAY

References

• requires prescription
• send nicotine to bloodstream quickly
• quickly relieves withdrawal symptoms & allows for good control over cravings
• easy to use
• FDA recommends: use for 3-month periods & no longer than 6 months

Side Effects

Risks

• not recommended for people with allergies, asthma, nasal polyps, or sinus problems
• keep away from small children & pets--even empty bottles contain harmful amounts of nicotine
• if have any skin contact, immediately rinse with water
• if bottle breaks or liquid leaks, wear gloves to avoid direct contact

most common side effects last ~1-2 weeks

nasal irritation

runny nose

throat irritation

coughing

watery eyes

• http://www.determinedtoquit.com/howtoquit/methodsofquitting/nicotinereplacementtherapies/
• https://www.icanquit.com.au/quit-guide/methods-to-quit/nicotine-replacement-therapy/how-nicotine-replacement-therapy-works
• http://healthpsych.psy.vanderbilt.edu/health-patch.htm
• https://www.icanquit.com.au/quit-guide/methods-to-quit/nicotine-replacement-therapy/how-nicotine-replacement-therapy-works

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