A Look at Nicotine Replacement Therapy

World No Tobacco Day highlights smoking risks and how to quit

(RxWiki News) Most people don’t need to be convinced of the dangers of smoking. The stats speak for themselves, but World No Tobacco Day is a good time to discuss some ways to quit smoking.

More than 16 million Americans have developed at least one smoking-related disease, such as lung cancer, according to BeTobaccoFree.gov.

Today, May 31, is World No Tobacco Day — a perfect day to quit smoking. Each year, thousands turn to nicotine replacement therapy (NRT) to wean themselves off of cigarettes. If you’re considering quitting, read on to learn more about this effective method.

Nicotine Replacement Therapy (NRT)

Nicotine is the primary addictive ingredient in cigarettes and other tobacco products. NRT is a treatment method that uses low doses of nicotine to ease cravings, without the addition of many of the toxins typically found in tobacco products.

NRT works differently for everyone — the more you smoke, the higher nicotine dose your body may need at first. The US Food and Drug Administration (FDA) recently determined that there do not appear to be safety concerns with beginning NRT, even if you haven’t completely stopped smoking.

Currently, there are five FDA-approved NRT products. If you’re considering kicking the habit, talk to your pharmacist and doctor to see if NRT is right for you.

Nicotine Gum

Nicotine gum is one of the most popular smoking-cessation methods available. This product can be bought over the counter and comes in 2- and 4-milligram strengths. When deciding which strength is right for you, consider whether you smoke more than 25 cigarettes per day, whether you smoke within 30 minutes of waking up and whether you have trouble not smoking in restricted areas. If any of these describe you, you may need to start with the higher dose.

When beginning, chew slowly until you feel tingling or detect a peppery taste. When this happens, hold the gum in your cheek without chewing until the feeling or taste fades. Do not eat or drink anything except water 15 minutes before and while chewing the gum. And do not chew more than 24 pieces of gum per day.

Nicotine gum has the added benefit of allowing you to control how much nicotine you receive. How many pieces of gum you chew per day and the nicotine strength can be tapered down as you continue treatment. Side effects include throat irritation, mouth sores, hiccups, jaw soreness and an increased heart rate. While a prescription is not necessary, it’s a good idea to talk to your doctor or pharmacist before beginning treatment.

Nicotine Lozenges

Like nicotine gum, nicotine lozenges can be purchased over the counter and are available in 2- and 4-mg strengths. Nicotine lozenges work by depositing nicotine in the mouth, where it is absorbed through the mucous membranes.

Suck on the lozenge until it is fully dissolved — about 20 to 30 minutes. Do not bite, chew or swallow the lozenge. Because some drinks can reduce the effectiveness of lozenges, do not eat or drink anything 15 minutes before and while using the lozenge. Nicotine lozenges are typically recommended for use as part of a 12-week program. The recommended starting dose is one lozenge every one to two hours for six weeks.

The number of lozenges per day is then tapered down for the remaining six weeks to wean the user off of nicotine. Do not exceed five lozenges in six hours or 20 lozenges in one day. If you feel that you need to use lozenges for more than 12 weeks, talk to your doctor. Side effects include insomnia, nausea, hiccups, coughing, heartburn, headaches and gas. Ask your doctor or pharmacist if nicotine lozenges are right for you.

Nicotine Patch

Nicotine patches are small patches worn on the body that administer small doses of nicotine through the skin. A patch is applied in the morning to areas of skin with minimal hair below the neck and above the waist. Over the course of a few weeks, higher-dose patches are switched for patches that contain less and less nicotine.

There are two types of patches available: one for heavy smokers that’s worn for 24 hours and one for light to average smokers that's worn for 16 hours. Which patch is right for you depends on how often you smoke and your body type.

Side effects include skin irritation, dizziness, racing heartbeat, insomnia, headache, nausea and muscle stiffness. If you experience any of these side effects, talk to your doctor about any changes you should make. Although nicotine patches can be purchased without a prescription, it’s best to talk to your doctor or pharmacist before beginning treatment.

Nicotine Inhaler

For some smokers, the physical motion of smoking is part of the addiction. Shaped like a cigarette, a nicotine inhaler is a small tube with a cartridge inside. The inhaler releases nicotine directly into the mouth, where it’s then absorbed into the bloodstream. Depending on your smoking habits, the starting dose can vary. As you continue treatment, dosages are decreased until they taper off completely.

Side effects include coughing, throat or mouth irritation and upset stomach. While this treatment is approved by the FDA, it’s only available with a prescription and is the most expensive type of NRT available. Talk to your pharmacist or doctor if you think a nicotine inhaler could be right for you.

Nasal Spray

Another common NRT comes in the form of a nasal spray. Nicotine nasal spray is widely used due to its fast-acting tendencies, which can relieve symptoms without delay. But because dependence is common with this product, the FDA recommends using the spray for a maximum of six months.

Using too much can also pose serious health risks, so follow your doctor’s directions carefully. And dispose of nasal spray bottles properly if you have pets or small children. Any amount of nicotine could harm them, and even empty bottles could contain enough to be toxic.

Side effects include nasal irritation, runny nose, watery eyes, coughing and throat irritation. Nicotine nasal spray is only available with a prescription, so talk to your pharmacist or doctor.

Speak with your pharmacist about the best NRT for you.

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Review Date: 
May 20, 2018