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Nicotine replacement therapy - how does it work and how effective is it?
Can NRT help me stop smoking?
Nicotine Replacement Therapy (NRT) can be useful if you want to give up smoking but are finding nicotine cravings or nicotine withdrawal hard to resist. Some people also use NRT products before they start a serious quit attempt, to reduce the number of cigarettes they smoke and make giving up easier.
Contents
How does NRT work?
NRT products release nicotine into your bloodstream to help reduce cravings and the physical side effects you might get from stopping smoking, such as feeling sick, headaches, irritability or dizziness. NRT is intended to wean you off of cigarettes, not to replace smoking on a long term basis. NRT products contain smaller amounts of nicotine without the tar and carbon monoxide in cigarettes and other tobacco products.
How effective is NRT?
Research suggests that NRT may increase your chance of quitting smoking by as much as 50% - 70%.
However, NRT isn’t a cure for tobacco addiction . You will still experience cravings and withdrawal symptoms when you stop using the nicotine replacement.
There are some alternatives to NRT which reduce cravings rather than replacing the nicotine you would normally inhale when smoking, such as Champix.
Whether you’re quitting smoking using NRT or a different treatment, attending regular catch-ups with other people who are trying to quit or a stop smoking advisor has been shows to greatly improve your chances of success.
Which different options for NRT are there?
There are several different types of NRT, and the most suitable one for you will depend on how heavy a smoker you are and whether you’ve tried any before.
Some smokers benefit from using more than one type of NRT at the same time. NRT is designed to be tapered off slowly, so you will need to gradually reduce the dose over time.
The number of cigarettes you smoke every day and the time you usually need to have your first cigarette will determine the strength and dose that’s best for you to start on. If you’re not sure, ask a pharmacist or your doctor.
Nicotine patches
Nicotine patches are worn on the skin and deliver a constant dose of nicotine over 16-24 hours. A 24-hour patch is best for you if you need a cigarette as soon as you wake up in the morning, otherwise a 16 hour patch should be fine.
Nicotine Inhalators
These are helpful for people who miss the habit and physical action of smoking a cigarette. They look like pens, come with cartridges that need to be replaced regularly, and are used to inhale nicotine vapour through a mouthpiece.
Nicotine Lozenges
Lozenges are dissolved in your mouth to release nicotine, starting with one lozenge every one to two hours.
Microtabs
Microtabs are small tablets that dissolve under your tongue. Dosage wise, you’ll usually start with one or two tablets hourly. You mustn't use more than 40 per day.
Chewing gum
Nicotine gum can be useful for the times when you find yourself tempted to reach for a cigarette. There’s a special way of chewing the gum that isn’t like standard gum, to make sure that the nicotine is effectively released.
Nasal spray
Nasal spray can help you combat strong cravings for nicotine rapidly. Nasal sprays deliver nicotine into your bloodstream faster than any other NRT product. You can use a nicotine nasal spray up to twice an hour in each nostril.
Mouth spray
Mouth sprays are similar to nasal sprays and a relatively new NRT option. You use them to spray nicotine in your mouth when you feel a craving for nicotine. You can use a mouth spray up to 64 times (sprays) per day.
Are NRT products suitable for children?
NRT preparations can be used by anyone over the age of 12 years except for Nicotinell® lozenges which should only be used by children under the age of 18 on doctor’s advice.
Alternatives
NRT is not the only available treatment to help you stop smoking. The prescription medication Champix reduces withdrawal symptoms and reduces enjoyment when smoking. Champix does not contain nicotine.
Can NRT cause side effects?
NRT products may cause some side effects.
The side effects of nicotine can be similar to nicotine withdrawal symptoms, so it can be difficult to establish whether you’re experiencing one or the other.
Some of the most common reported side effects include headaches, or feeling sick and dizzy.
Nicotine patches can sometimes cause skin irritation or rashes.
NRT nasal sprays can cause nosebleeds, along with sneezing, a sore throat, runny nose and watery eyes.
NRT that’s taken by mouth can cause irritation in your mouth and throat, and lead to dryness.
Sometimes you might experience an increase in the amount of saliva you produce when you first start using NRT, which might lead to nausea, indigestion and hiccups from swallowing nicotine in the saliva. It’s also worth noting that if you use oral NRT, it’s best not to drink soft drinks, fruit juice or coffee for 15 minutes beforehand as they can reduce the amount of nicotine you absorb.
Can you use NRT if you’re pregnant?
If you’re pregnant and smoking, you should visit a stop smoking advisor for advice. While it’s better to use NRT than to continue smoking, NRT may not be suitable for you during pregnancy.
During pregnancy, it is best to avoid nicotine entirely.
Other stop smoking medications like Zyban and Champix aren’t recommended when you’re pregnant.
Breastfeeding
Although nicotine you can be passed on to your baby via breast milk, the amount of nicotine which enters your breast milk from using NRT is thought to be small.
Using NRT is preferable to exposing your baby to secondhand smoke.
Before you use NRT while breastfeeding, speak to a doctor.