Types Of Nicotine Replacement Therapy
Struggling to quit smoking? Tried many times, but the habit’s returned? Maybe it’s time you considered trying Nicotine Replacement Therapy (NRT).
NRT increases the chances a person quits smoking by some 50% to 70% and are medically-approved methods to take nicotine that result in a reduction or elimination of tobacco smoking or chewing. NRT reduces a person’s cravings for nicotine.
Top 5 Types of NRT
There are five main types of NRT, which may be used singly, or in combination for potentially better results in smoking cessation. They deliver low doses of nicotine, without the harmful side effects of smoking or chewing tobacco. The therapies are listed below, with helpful hints on the best way to use them.
1. Chewing gum: releases nicotine into a person’s bloodstream through the mouth while chewing. Typically, a person will chew nicotine gum 15 minutes after eating or drinking, for up to 30 minutes, until the nicotine cravings subside.
Each piece of gum is equivalent to 1 to 2 cigarette’s worth of nicotine, depending on the dosage level. People with a significant cigarette habit have more success on the 4-mg dose. It is recommended that people just starting to quit only chew 1 to 2 pieces of gum per hour, and no more than 20 pieces per day.
Once the gum has developed a peppery taste during chewing, place it between the gum and cheek, letting the nicotine be absorbed into the lining of the mouth. It is ideal to stop needing to use the gum within six months.
2. Lozenges or pastilles: Like gum, nicotine is released from lozenges or pastilles into a person’s bloodstream while being chewed in the mouth. The dose can be controlled better through lozenges than gum. A prescription is not required for lozenges.
People should avoid drinking anything 15 minutes prior to using a lozenge or pastille. They should also avoid smoking, as the nicotine from the combination of smoking and chewing lozenges can result in nicotine poisoning.
3. Adhesive nicotine patches: transdermal patches that release nicotine in different doses through the skin into the bloodstream. These have been shown to be effective in double-blind trials. A single patch is worn, and replaced each day. Patches are placed below the neck on the upper body, on hair-free skin, for a period of 24 hours for best results.
4. Nicotine Inhaler: A metered-dose inhaler (MDI) allows people to get a consistent measured dose of nicotine, without using tobacco. Inhalers are quick-acting, similar to gum, but much faster than patches.
When a user inhales a puff of nicotine vapor, it is absorbed in the lining of their mouth, with very little vapor going into the lungs. Each inhaler delivers nearly 400 puffs of nicotine vapor and you can “puff” them for about 20 minutes at a time, up to 16 times a day.
Inhalers satisfy oral urges and are considered much healthier than cigarettes as it takes around 80 puffs to get an equivalent amount of nicotine as from one cigarette. Some users experience coughs or throat and mouth irritations with inhaler use. Inhalers typically are obtained with a prescription from a physician.
5. Nicotine nasal spray: Like nicotine inhalers, nasal sprays deliver a quick-acting dose of nicotine, with levels peaking within 5 to 10 minutes of usage. Nasal sprays come in a liquid that a person can spray into each nostril of their nose, to deliver a dose of nicotine.
Nasal spray can be used alongside nicotine patches. Like with other forms of NRT, users must stop smoking completely when using a nasal spray or they run the risk of developing nicotine poisoning. Sprays can irritate the eyes, nose and throat, but side effects often diminish in a few days.
Are There Any Side Effects of NRT?
General side effects of NRT include nausea and other digestive problems, headaches and difficulties getting to sleep, and/or vivid dreams in the first few days. This last effect is most common with the patch but tends to pass. Some users find it helpful to not wear the patch at bed time.
Commonly reported side effects of the chewing gum include irritation of the mouth, hiccups and nausea. Patches can cause a dry mouth and skin irritations and inhaler use can result in a cough, headaches or a runny nose.
Special Concerns
Serious side effects of ongoing use of NRT can include continued addiction and nicotine poisoning. Nicotine patches are considered safe to use by the majority of people with stable blood circulation or heart problems. Unhealthy cholesterol levels (lower HDL) originally caused by smoking will not change until use of nicotine patches (and smoking) has ceased.
Nicotine Replacement Therapy may not be completely safe for pregnant women, causing a faster heart-rate in the unborn child. All nicotine products must be kept away from children. Nicotine is a poison. If you suspect a child has been exposed to a nicotine replacement product, call a poison control center or doctor right away.
Nevertheless, the benefits of NRT in helping people to cease smoking or chewing tobacco are so well established that NRT products are included on the World Health Organization (WHO) List of Essential Medicines.
NRT is Complementary to Smoking Cessation Programs
Like with many addiction therapies, nicotine replacement therapy has been shown to be more effective when combined with a formal smoking cessation program where smokers wanting to quit can get information, advice, motivation and support to help them stop smoking or chewing tobacco.