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Easy Ways To Minimize Triggers When Trying To Quit
Easy Ways To Minimize Triggers When Trying To Quit
Step-by-Step Guide to using "The Patch"
Step-by-Step Guide to Using "The Patch"
Science Behind Nicotine Lozenges: How They Help Quit Smoking
Science Behind Nicotine Lozenges: How They Help Quit Smoking
NRT To Help You Quit
How To Support Someone on Their Quit-Vaping Journey
Is Motivational Interviewing Effective? A Look at 5 Benefits
10 Common Myths About Smoking And Quitting
How To Know If Nicotine Replacement Therapy Is Right For You.
What Is NRT?
NRTs intend to replace the nicotine found in cigarettes and other tobacco products. These treatments can help reduce cravings and also appease withdrawal symptoms.
NRTs can be a good option for most individuals who are looking to quit smoking. However, teens, pregnant women and those with serious health conditions should talk to a doctor before they start using any type of NRT. Individuals often need to be at least 18 years old to purchase NRTs or any products that contain nicotine, as well. NRTs can be especially good for smokers who are highly dependent and have tried quitting on their own with no success.
Different Types of NRTs
There are many NRT options that fit individuals’ different habits, lifestyles and budgets. There are also options for both short and long-term use. Most NRTs have been found to be safe and effective, even if someone has had a couple of cigarettes while simultaneously using an NRT.
Different types of NRTs can also be safely combined. Some individuals find it works best for them to combine a short-acting NRT, such as gum, with a long-acting NRT, such as the patch, when they are trying to quit cigarettes and other tobacco products. Out of all the NRT options, it has been found that individuals are most likely to use the gum and patch correctly.
Nicotine Gum
Nicotine gum is a well-known, effective NRT. While 2 milligrams is a standard dose, highly dependent smokers who are looking to quit could use the gum containing up to 4 milligrams. Individuals typically chew one to two pieces of gum every four hours as they start trying to quit smoking or using other tobacco products. It is advised not to chew more than 20 pieces of nicotine gum a day.
One should also wait at least 15 minutes to chew a piece of nicotine gum after drinking an acidic beverage, such as coffee, tea or soda. For the best dose, the gum should be chewed slowly, then kept between a person’s gum and cheek once the gum’s peppery taste is released into the mouth.
Once chewed, the gum delivers nicotine to the blood and then brain within minutes. Some research shows that it is best to quit using this over-the-counter option within 12 weeks, though other research has found that the gum works best to help individuals quit cigarettes and using other tobacco products if used for at least 14 weeks.
Nicotine Patch
The nicotine patch is another NRT option. The patch is placed on the skin and releases a steady dose of nicotine throughout the day. Patches can be obtained both with and without a prescription.
Most patches are worn for one day and replaced after 24 hours. Withdrawal symptoms are fewer if the patch is worn for 24 hours straight. It sticks best if placed on a hairless spot or spot with minimal hair. Nicotine patches come in different doses. For those who are looking to quit and previously smoked 10 or fewer cigarettes per day, or for those who weigh less than 99 pounds (or 45 kilograms), it is best to start with a lower-dose patch, such as 14 milligrams.
To help fully quit nicotine, the patch’s dose can be lowered over a few weeks as one is gradually weaned off of using cigarettes and tobacco products. For those who are having trouble quitting, they can use a higher-dose patch to help them fully quit. The patches can be obtained both with and without a prescription.
The nicotine patch has a quit rate of 23-27%.
Nicotine Patch
The nicotine inhaler is another NRT option. The inhaler comes with a mouthpiece and a cartridge containing about 10 milligrams of nicotine. Using the inhaler mimics the “hand-to-mouth ritual” of smoking a typical cigarette, so it can be a good option for those who crave the technique used to smoke a cigarette.
However, most of the nicotine from this device is delivered into the oral cavity, esophagus, and stomach, despite being termed an inhaler. Only 4% of the nicotine is delivered into the lung. The absorption rate for the inhaler is similar to the absorption rate for the gum.
Nicotine inhalers tend to be obtained with a prescription. Their use can have a quit rate up to 25%.
Nicotine Lozenges
Nicotine lozenges generally come in tablet form and are taken orally, where they dissolve in the mouth. It takes about 30 minutes for a lozenge to dissolve. This over-the-counter-only option has a similar dose to that of nicotine gum, and lozenges also come in 2 milligram and 4 milligram doses. The nicotine from the lozenges is absorbed into mucosa before being delivered to the rest of the body’s system.
The lozenges are a good NRT option for individuals who like the immediate, intermittent nicotine dose that the gum gives, but do not like chewing gum.
Nicotine lozenges can have a quit rate of up to 24%.
Nicotine Nasal Spray
As an NRT, the nasal spray can deliver nicotine very quickly. This prescription-only option absorbs more quickly into the bloodstream than other NRTs. The device generally delivers .5 milligrams of nicotine per 50-uL squirt. The dosage is generally two squirts or one per each nostril. Those new to the nasal sprays are advised to start with one or two doses per hour, with a maximum of 40 doses per day.
Nicotine nasal sprays can have a quit rate up to 27%.
Other Options for Quitting
In addition to NRTs, individuals can try a variety of other techniques to help curb their cigarette smoking and tobacco use habits. These treatments range from natural stress and anxiety relief strategies to cognitive behavioral therapies.
When quitting smoking, individuals can experience withdrawal symptoms, which include anger, frustration, irritability, anxiety, and depression.
As many people turned to cigarettes or other tobacco products as a stress relief or stress management tool, it can be hard to find suitable alternatives once one has taken steps to quit smoking. However, individuals can try relaxation techniques and other methods to cut down on stress in a healthy way instead of through smoking. Some key stress-reduction techniques include the following:
Taking Slow, Deep Breaths
Taking slow, deep breaths is a calming technique. Thus, it can also be helpful to try to calm down if one feels anxious and is craving a cigarette.
Practicing Self-Care Habits
Self-care habits can include taking warm baths, journaling and other options to stay calm while quitting smoking.
Exercising and Staying Active
There are many types of exercise that can help one stay calm, centered and help quit smoking. These include hiking, swimming, going for long walks and practicing yoga. One can try out different exercises to see what they most enjoy. Stretching before and after exercise, and in general, is also good for the muscles and can help one relax.
Practicing Relaxation Techniques
Meditation is an ideal relaxation technique that can help one stay calm and relieve anxiety that might lead to wanting to smoke. It is also important to get enough rest.
Cutting Coffee
Many smokers crave a cigarette with coffee, so switching to tea while quitting could be a good option to cut the craving.
Reaching out to Friends, Family and Other Social Support Networks.
Having a solid social support network can encourage individuals to meet their quitting goals and empower them to do so. Humans are social beings who do well with support from others in difficult times, and smoking can be a challenging task to take on alone.
While these treatments may not work for everyone, they can be an initial step to try and quit smoking, especially for individuals who are not yet severely dependent or use cigarettes to manage stress, anxiety and other issues.
Quitting Is Possible
Nicotine is an addictive chemical, and many who find themselves wanting to quit cigarettes or other tobacco products may struggle to do so as a result. Thus, NRTs are a good option for many individuals who would like to quit smoking, aside from pregnant women, teens, and those with serious health conditions who have not yet consulted a doctor about using NRTs.
From the gum to lozenges to the patch to inhalers to sprays, the plethora of NRT options means individuals can find the best one for their budget, habits and lifestyles.
NRTs and other quitting strategies can also work best when combined with a quit plan. A variety of quitting hotlines, programs and apps can be used to supplement quitting efforts sought by those using NRTs. Greater success in quitting is also expected if a combined, targeted approach is used to quit smoking cigarettes and using other tobacco products.
Referenced from: Nicotine Patch vs. Gum. Select the Best Nicotine Replacement (smokingaddiction.org)
Easy Ways To Minimize Triggers When Trying To Quit
Quit smoking aids are valuable to those of you who have decided to quit smoking or are trying to quit smoking. Nicotine replacement products help manage withdrawal symptoms by gradually decreasing your nicotine intake to lessen your dependence on it over time. However, you can still face challenges whenever you’re exposed to external factors that could potentially trigger your craving to start smoking again.
We map out strategies on how you can minimize these triggers when you’re trying to quit smoking.
Remove Cigarettes From Your Home and Workplace
The easiest way to get smoking out of your system completely is to throw away all the cigarettes and other tobacco products from your workplace, car, and home. Wash your clothes or anything that smells remotely like cigarette smoke. Remember: out of sight, out of mind!
Get Regular Exercise
A major trigger that can push you to find relief back to smoking is stress. Stress and anxiety can significantly increase your urge to smoke and derail you on your journey to quitting. A way to divert or to reverse your feelings of stress is to get regular exercise. Getting regular exercise can help your body release endorphins (happiness hormones), which can boost the overall positive feeling in the body.
Keep A Journal
Refocusing can help you deal with your craving for smoking, and journaling is a helpful method you can try to take your mind off it and put your thoughts to paper.
First, write down all your reasons for quitting. Whether it’s improving your health, saving money or wanting to set a good example for your children, write them all down. This is so you can remind yourself of all the reasons why you decided to quit in the first place whenever the urge to smoke sets in. Quitting is never easy. Especially when many factors can hinder you from recovering. Keeping your feelings in check can help you navigate your way and help you on your journey to quitting.
Avoid Smokers And Designated Smoking Areas
Another way to minimize triggers is to recognize situations that will make you want to smoke and making a conscious decision to avoid them. These situations may include avoiding designated smoking areas outside establishments or buildings.
Alternatively, you can also hang out less with people who smoke. Practice saying, “No, thanks,” when they invite you. Spend more time with people who are non-smokers. Plan activities together with people who are also trying to quit smoking for you to get your mind off smoking.
Take On A New Hobby
You may find yourself taking comfort solely from smoking. Though you may find it satisfying and enjoyable, smoking is an addictive habit that slowly eats your time and life away. The time you spend smoking is time you can never take back. To get back on track, find a new creative outlet that will allow you to spend your time more productively. Rediscover what your interests are and do it! Find a new hobby that stimulates you whether it be in the form of art, music, or dance. This will allow you to re-center your life and keep your life moving forward without needing to depend or seek pleasure from the habit.
Cope With Withdrawal Symptoms With NRT Products
One of the most daunting challenges when quitting smoking is addressing withdrawal symptoms. Withdrawal can increase your chances to crave for cigarette smoke. Once you stop smoking, you may experience physical symptoms such as tremors, insomnia, irritability, fatigue, and more. Don’t worry, because that’s just your body’s way of coping through the change. Though it’s unpleasant, it’s important to remember that these symptoms are only temporary.
An excellent way to help you manage withdrawal symptoms and cigarette cravings is by taking NRT products or quit smoking aids. Agape Recovery’s nicotine replacement therapy products (nicotine lozenges and patches) are here to help FREE OF CHARGE! Let’s help you quit smoking today!
Referenced from: Minimizing Triggers When You’re Trying to Quit | Kea Health (quitsmokingdirect.com)
Step-By-Step Guide To Using "The Patch"
- For best results, make sure you start on the right dose. The nicotine patch comes in three strengths (7 mg, 14 mg, 21 mg). The right dose for you depends on how much you currently smoke. If you smoke more than 10 cigarettes per day, consider starting on the 21 mg patch. Don’t wear two patches at once unless directed to do so by your healthcare provider. Over time (typically after 8 to 12 weeks), you should lower the dose with the goal of stopping use of the patch completely.
- The nicotine patch is typically worn for 24 hours. The patch can even be worn when showering or bathing. When you wake up, put a fresh patch on clean skin and wear it for a full 24 hours. If you find that you are having vivid dreams or that your sleep is disturbed, you can take the patch off before bed and put a new one on the next morning.
- Put the patch on clean, dry, hair-free skin on the upper body. Usual places to put the patch are the upper chest, upper arm, shoulder, back, or inner arm. Avoid putting the patch on areas of irritated, oily, scarred, or damaged skin. Remove the patch from the foil package, peel off the protective strips, and immediately apply the patch to your skin. Press down to ensure the patch sticks to your skin.
- Wash your hands with soap and water after you apply the patch to wash away any nicotine you may have gotten on your fingers when applying the patch.
- To avoid skin irritation, put the patch on a different area of your upper body each day. Avoid wearing the patch in the same place more than once per week. If the patch loosens or falls off, replace it with a new one.
- When changing your patch, remove the patch carefully and dispose of it by folding it in half with the sticky sides touching. Then apply a new patch to a different part of your upper body.
- Keep out of reach of children and pets. Nicotine patches – even used patches – may have enough nicotine to make children and pets sick. In case of accidental use or ingestion, contact a Poison Control Center right away (1-800-222-1222).
- Quitting smoking may make some people depressed or anxious, whether quitting with medication or not. Get help if you have feelings of depression or anxiety that last for more than two weeks or that get worse.
- Combine the patch with nicotine gum or lozenge to better manage cravings. You can start using both the patch and gum or lozenge, or you can add gum or lozenge later, if you continue to have withdrawal symptoms. Patches can provide a steady level of nicotine in the body to help lessen withdrawal, while the gum or lozenge can be used to more quickly relieve cravings as they happen.
- If you have a lot of cravings while using the patch, you may not be using a strong enough dose. Consider stepping up to a higher dose. If you are already on the highest dose, talk with your doctor or other healthcare provider for help with dosing. You can also consider adding gum or lozenge, as described above.
- What if I slip up and smoke while using the patch? You do not need to stop using the patch if you slip up and smoke while wearing it. Throw away your cigarettes and get back on track with your quit attempt. Keep using the patch as directed above.
- For best results, use the nicotine patch as part of a program that includes coaching support.
Referenced From: How to Use Nicotine Patches | Quit Smoking | Tips From Former Smokers | CDC
Science Behind Nicotine Lozenges: How They Help Quit Smoking
Nicotine lozenges are an essential part of the arsenal against smoking addiction, designed to alleviate the grip of nicotine withdrawal through a measured release system. These lozenges function by substituting the rapid high from cigarettes with a steadier, more controlled exposure to nicotine, thereby blunting the severe spikes and troughs that challenge the quitting process. Understanding exactly how this method manipulates neurological pathways to dampen the urge to smoke is vital for evaluating its efficacy in comparison to other cessation aids. What remains to be explored is whether the benefits of nicotine lozenges extend beyond mere symptom management to foster long-term cessation success.
Exploring the understanding of nicotine lozenges offers insight into a pivotal tool for smoking cessation, but delving deeper into the benefits of choosing nicotine lozenges reveals their potential as a superior alternative to traditional cessation methods. By comparing nicotine lozenges to other nicotine replacement therapies, one can discern their unique advantages, including user preference tied to nicotine lozenge flavors. For those seeking to maximize their quitting strategy, understanding the best way to use nicotine lozenges is key, as is recognizing their safety profile compared to smoking, offering a holistic approach to combating nicotine addiction.
Understanding Nicotine Addiction
Nicotine addiction, characterized by a relentless craving for tobacco, is a complex physiological and psychological dependency that develops primarily due to the presence of nicotine in tobacco products.
It manipulates the brain’s reward system, compelling individuals to continue use despite adverse consequences.
Overcoming this addiction requires not only physical detoxification but also significant behavioral and psychological adjustments to break the cycle of dependency.
Composition of Nicotine Lozenges
To combat nicotine addiction effectively, nicotine lozenges are formulated with specific ingredients designed to alleviate cravings and withdrawal symptoms.
These lozenges primarily contain therapeutic nicotine, which substitutes the nicotine usually obtained from cigarettes. Additionally, they include flavorings to enhance palatability and binders that guarantee the lozenge dissolves slowly.
This controlled release aids in managing the physiological aspects of nicotine dependence without smoking.
Mechanism of Action
Understanding how nicotine lozenges function involves examining their interaction with the body’s neurological system. When consumed, these lozenges release nicotine slowly, which then enters the bloodstream.
This nicotine binds to nicotinic acetylcholine receptors in the brain, mimicking the effects of smoking by reducing withdrawal symptoms and cravings. This process helps smokers decrease their dependence on cigarettes by managing withdrawal in a controlled manner.
Gradual Nicotine Reduction
Nicotine lozenges facilitate a gradual reduction in nicotine dependency, aiding smokers in their cessation efforts. By allowing users to control their dosage, they can methodically lower their nicotine intake over time.
This tailored approach helps manage withdrawal symptoms more effectively, making the shift away from smoking smoother and more bearable. It supports the body’s adjustment to lower levels of nicotine, promoting a healthier quitting process.
Referenced From: Science Behind Nicotine Lozenges – Kea Health
10 Common Myths About Smoking And Quitting
- Nicotine is the major toxic ingredient in cigarettes.
- Nicotine replacement therapy (NRT) is as harmful as smoking.
- Smoking while using NRT is dangerous.
- Using more than one form of NRT (such as nicotine patch and nicotine mouth spray) is unsafe.
- Smoking helps to relieve stress.
- Cutting down your cigarettes or smoking mild cigarettes reduces the harm from smoking.
- Smoking just a few cigarettes daily is fairly harmless.
- Hypnotherapy or acupuncture are effective quitting strategies.
- It is too late to quit. The damage is done.
- Champix (varenicline) can make you depressed or suicidal.
Nicotine is the major toxic ingredient in cigarettes
Wrong. Nicotine is the addictive drug in cigarettes but it is the other substances that cause the most harm.
Nicotine in dosages present in cigarettes does not cause heart attacks, cancer or lung damage.It is the other 7,000 toxins and chemicals in tobacco which are harmful, particularly tar and carbon monoxide. There are 70 known cancer causing agents in tobacco smoke.
Nicotine replacement therapy (NRT) is as harmful as smoking
Wrong. NRT (patch, gum, lozenge, inhalator, mouth spray) is always much safer than smoking.
NRT replaces some of the nicotine your body receives from smoking, but at a much lower level.Nicotine from NRT has few side-effects. Most of the harm from smoking is from the tar and carbon monoxide which are not found in nicotine replacement products.
Nicotine from NRT is delivered much more slowly and at lower levels than from smoking. As a result, the risk of becoming addicted to NRT is very small. In any case, long term use of NRT carries very littlerisk and is much safer than continuing to smoke.
Smoking while using NRT is dangerous
Wrong. Smoking while using NRT is no more dangerous than smoking.
Studies have found no significant side-effects from using NRT while smoking. When receiving nicotine from NRT, smokers generally cut down their cigarette intake or smoke less intensely as they need less nicotine from cigarettes.
Using more than one form of NRT (such as nicotine patch and nicotine mouth spray) is unsafe
Wrong. Combining more than one form of NRT can be used safely to help you quit.
Combining a nicotine patch with the nicotine mouth spray, lozenge, gum or inhalator causes no significant increase in side-effects over just using the patch alone. The combination gives better relief of cravings and nicotine withdrawal symptoms and increases the chance of quitting successfully, particularly for those who are very nicotine dependent. Combination therapy is now widely recommended by tobacco treatment specialists.
Smoking helps to relieve stress
Wrong. Research has shown that smoking increases stress levels overall.
Much of the apparent calming effect of a cigarette is simply due to the relief of symptoms (such as irritability, anxiety and restlessness) caused by nicotine withdrawal. Also, some of the relaxation from smoking is from taking a break and a few deep breaths, not the cigarette itself.
Smoking increases stress by causing frequent withdrawal periods during the day between cigarettes. Further stress is created by the guilt and shame of smoking and by concerns about the health effects. Furthermore, nicotine is a stimulant and releases stress hormones such as adrenaline. Research studies have shown that ex-smokers report feeling less stressed than when they were smoking.
Cutting down your cigarettes or smoking mild cigarettes reduces the harm from smoking
Wrong. Cutting down your cigarette intake or changing to milder cigarettes does not improve your health and does not significantly reduce your risk of dying from a smoking-related disease.
The reason is that smokers subconsciously adjust their smoking when they cut down or smoke weaker cigarettes (compensatory smoking). When you smoke fewer or weaker cigarettes, you smoke each cigarette more intensely to extract more nicotine and keep your nicotine level in the comfort zone. You take more puffs and deeper puffs from each cigarette to compensate for the reduced number or weaker cigarettes.
Smoking just a few cigarettes daily is fairly harmless
Wrong. The research shows the health risks from light smoking are substantial.
Smokers of only 1-4 cigarettes per day have 3 times the risk of dying from a heart attack and 3-5 times the risk of dying from lung cancer compared to non-smokers. Overall their risk of death from any cause is increased by 57% compared to non-smokers.
Other conditions proven to be increased in light smokers include gastrointestinal cancers (oesophagus, stomach, and pancreas), lower respiratory tract infections, cataracts, reduced fertility in men and women, ectopic pregnancy, placenta praevia and reduced bone mineral density.
Hypnotherapy or acupuncture are effective quitting strategies
Wrong. There is no good evidence that hypnotherapy or acupuncture are effective in helping smokers quit.
These treatments generally do no harm and some people will quit successfully due to the placebo effect. However it would make more sense to use other treatments that are proven to be effective.The longer you delay successful quitting with unproven strategies, the more damage is being done to your body.
It is too late to quit. The damage is done
Wrong. The damage from smoking improves quickly after quitting at any age.
Many of the health effects of smoking reverse quite rapidly after quitting at any age. Quitting before the age of 50 reduces your risk of dying in the next 15 years by half. The risk of having a heart attack falls by 50% after about 3 years. In the case of lung cancer, your risk drops to half in 10 years.
The benefits of quitting are greatest when you stop earlier. However, even quitting at 60 years of age increases life expectancy by 3 years compared to those who continue to smoke.
Champix (varenicline) can make you depressed or suicidal
Wrong. There is no scientific evidence that Champix causes these symptoms.
There have been reports that some patients using Champix became depressed, agitated, had changes in their behaviour, suicidal thoughts or actually committed suicide. However, a careful review of all the scientific evidence found no evidence that Champix was the cause. Recently, there have been several studies of Champix in smokers suffering from depression and schizophrenia. The patients using Champix had no more side-effects of this type than those using placebo.
Stopping smoking can cause the symptoms mentioned above and this is probably the main cause of those reports, not Champix. Nevertheless, if you use Champix to help you quit, it is important to report any changes in your mood or behaviour to your doctor.
Champix is the most powerful anti-smoking medication available and has helped many people to quit who otherwise could not. It is safe and well tolerated. Side effects can occur with any drug but should be weighed up against the enormous health risks from continuing to smoke.
Referenced From: 10 common myths about smoking and quitting – Tobacco and smoking (nsw.gov.au)
NRT To Help You Quit
Nicotine is the main addictive substance in tobacco. When a person uses tobacco, many parts of the body get used to having nicotine in them. When a person quits tobacco, they also quit nicotine and will likely have withdrawal symptoms from it. This is because the body has to get used to not having nicotine.
The nicotine in tobacco leads to actual physical dependence. This can cause unpleasant withdrawal symptoms when a person tries to quit. Nicotine replacement therapy (NRT) gives you nicotine – in the form of gum, patches, sprays, inhalers, or lozenges – but not the other harmful chemicals in tobacco. NRT can help relieve some of the physical withdrawal symptoms so that you can focus on the psychological (emotional) aspects of quitting.
Many studies have shown using NRT can nearly double the chances of quitting smoking. It hasn’t been studied as much for quitting smokeless tobacco, but the NRT lozenges may help.
People who smoke and are significantly dependent on nicotine should consider nicotine replacement or drug therapy to help them quit. Signs of severe nicotine dependence include:
- Smoking more than 1 pack a day
- Smoking within 5 minutes of waking up
- Smoking even while sick
- Waking up at night to smoke
- Smoking to ease symptoms of withdrawal
The more of these that apply, the more serious the nicotine dependence.
How does nicotine replacement therapy work?
Nicotine replacement therapy (NRT) can help with the difficult withdrawal symptoms and cravings that most people say is their only reason for not giving up tobacco. Using NRT reduces those symptoms.
Many people can quit tobacco without using NRT, but most of those who attempt quitting do not succeed on the first try. In fact, people trying to quit usually need many tries before they’re able to quit for good. Most people who try to quit on their own go back to smoking within the first month of quitting – often because of the withdrawal symptoms. But the good news is that many do succeed. In fact, there are now more people who formerly smoked than people who currently smoke!
Together with counseling or other support, NRT may help increase the number of smokeless tobacco users who quit, too.
You can start using nicotine replacement therapy (NRT) as soon as you throw away your tobacco. You don’t need to wait a certain length of time to put on the patch or start using the gum, lozenge, nasal spray, or inhaler. Double-check this information with the instructions on your chosen method of nicotine replacement, but in general there’s no need to wait to start using NRT.
Getting the most from nicotine replacement therapy
Nicotine replacement therapy (NRT) only deals with the physical dependence. It’s not meant to be the only thing you use to help you quit smoking. You’ll need other methods that help with the psychological (emotional and mental) part of tobacco, such as a quit program. Use these support systems during treatment with NRT and for at least a few months after you quit. Studies have shown that this approach – pairing NRT with a program that helps to change behavior – can improve your chances of quitting and staying quit compared to approaches that use only one method.
The best time to start NRT is when you first quit. Often people first try to quit tobacco on their own then decide to try NRT a day or more into quitting. This does not give you the greatest chance of success, but don’t let this discourage you. There are many options for quitting and staying quit. Just remember that it often takes many tries.
The Food and Drug Administration (FDA) has approved the NRT products discussed here as effective aids for helping people quit smoking. None of these products has been FDA-approved specifically to help people quit smokeless tobacco. Still, studies are being done, and some have shown the lozenge form may help.
Who should not use nicotine replacement therapy?
The US Agency for Healthcare Research and Quality states that nicotine replacement therapy (NRT) is safe for all adults who want to quit smoking except pregnant women and teens. Still, it’s best to discuss NRT use with your health care provider before starting it. You may have medical problems that should be considered. When deciding whether to use NRT, the benefits of quitting tobacco must outweigh the potential health risks of NRT for each person.
People who are still smoking or using any other form of tobacco should not use NRT. The companies that make NRT products warn that you should not use them if you’re still using tobacco, and the FDA has not approved them to be used in this way. Get the advice of a health care provider if you want to use NRT while continuing to smoke or chew.
NRT has not yet been proven to help people who smoke fewer than 10 cigarettes a day. But many tobacco treatment centers do use NRT for people who are “light smokers.” Talk with your health care provider about a lower dose of NRT if you smoke less than that but feel you need nicotine replacement.
Types of nicotine replacement therapy
The US Food and Drug Administration (FDA) has approved 5 forms of nicotine replacement therapy (NRT):
- Patch
- Gum
- Nasal spray
- Inhalers
- Lozenges
Note that the patch, gum, and lozenge can be purchased over the counter, while the nasal spray and inhaler require a prescription.
The most important thing to do with any form of NRT is read and follow the package instructions very carefully.
Nicotine patches (transdermal nicotine systems)
Patches can be bought with or without a prescription.
Patches give a measured dose of nicotine through the skin. You’re weaned off nicotine by switching to lower-dose patches over a course of weeks.
Many different types and strengths of patches are available, including 16-hour and 24-hour patches. Which patch you should use depends on how many cigarettes you smoke each day. Package instructions tell you how to use them, and list special considerations and possible side effects.
How to use nicotine patches: Depending on body size and smoking habits, most people who smoke should start using a full-strength patch (15-22 mg of nicotine) daily for several weeks, and then use a weaker patch (5-14 mg of nicotine) for another several weeks. The patch is changed every day. It should be put on in the morning on a clean, dry area of the skin without much hair. It should be placed below the neck and above the waist – for instance, on the upper arm or chest. The FDA has approved using the patch for a total of 3 to 5 months, but using it longer is better than going back to smoking.
Possible side effects of the nicotine patch include:
- Skin irritation (redness and itching)
- Dizziness
- Racing heartbeat
- Sleep problems or unusual dreams (more common with the 24-hour patch)
- Headache
- Nausea
- Muscle aches and stiffness
No one has all of the side effects, and some people have none. Some side effects, such as racing heart, may mean the dose of nicotine is too high for you. Stop using the patch and talk to your health care provider if this happens. You could also have nicotine withdrawal symptoms if your NRT dose is too low.
What to do about side effects
- Try a different brand of patch if your skin becomes irritated.
- Reduce the amount of nicotine by using a lower-dose patch.
- Sleep problems may go away in 3 or 4 days. If not, and you’re using a 24-hour patch, try switching to a 16-hour patch.
- Stop using the patch and try a different form of NRT.
Nicotine gum (nicotine polacrilex)
Nicotine gum can be bought without a prescription.
Nicotine gum is a fast-acting form of replacement. Nicotine is taken in through the mucous membrane of the mouth. You can buy it over the counter (without a prescription). It comes in 2 mg and 4 mg strengths.
In choosing your dose, think about whether you
- Smoke 25 or more cigarettes per day
- Smoke within 30 minutes of waking up
- Have trouble not smoking in restricted areas
If any of these describe you, you may need to start with the higher 4mg gum dose.
How to use nicotine gum
For best results, follow the instructions in the package. Nicotine gum is not meant to be used like regular gum. Chew the gum slowly until you get a peppery taste or tingle. Then tuck it inside your cheek until the taste fades. Chew it to get the peppery taste back, and hold it again. Do this off and on for 20 to 30 minutes. Food and drink can affect how well the nicotine is absorbed, so don’t eat or drink for at least 15 minutes before and during gum use. This is important because many people misuse the nicotine gum and chew it like regular gum instead of how it should be used.
An advantage of nicotine gum is that it allows you to control the amount of nicotine you get. The gum can be used as needed or on a fixed schedule during the day. The most recent research has shown that scheduled dosing works better. A schedule of 1 to 2 pieces per hour is common. On the other hand, with an as-needed schedule, you can use it when you need it most – when you have cravings.
Chew no more than 24 pieces of gum in one day. Nicotine gum is usually recommended for 6 to 12 weeks, with the maximum being 6 months. Tapering down the amount of gum you use as you approach 3 months may help you stop using it. But it is better to keep using the gum rather than starting to smoke again.
Possible side effects of nicotine gum include:
- Bad taste
- Throat irritation
- Mouth sores
- Hiccups
- Nausea
- Jaw discomfort
- Racing heartbeat
The gum can also stick to and damage dentures and dental work.
Stomach and jaw discomfort are usually caused by improper use of the gum, such as swallowing the nicotine or chewing too fast. No one has all of the side effects, and some people have none. If your heart is racing or beating irregularly, stop using the gum and talk to your health care provider. You could also have nicotine withdrawal symptoms if your NRT dose is too low.
Nicotine nasal spray
Nicotine nasal spray is only available by prescription.
The nasal spray delivers nicotine to the bloodstream rapidly because it’s absorbed through the nose. It relieves withdrawal symptoms very quickly and lets you control your nicotine cravings.
How to use nicotine nasal spray
Most people are told to use 1 to 2 doses per hour. (1 dose = 2 sprays, 1 in each nostril.) At least 8 doses (16 sprays) each day may be needed when you first start, but use as directed by your health care provider. You should not use more than 40 doses (80 sprays) per day. Instructions can vary. Talk to your provider about the plan that’s best for you.
The FDA recommends that the spray be prescribed for 3-month periods and that it not be used for longer than 6 months.
Possible side effects of nicotine spray
The most common side effects of the spray get better in about 1 to 2 weeks and can include:
- Nasal irritation
- Runny nose
- Watery eyes
- Sneezing
- Throat irritation
- Coughing
Other side effects are related to nicotine:
- Racing heart
- Nervousness
- Headache
No one has all of the side effects, and some people have none. Some side effects, such as racing heart, may occur because you’ve gotten too much nicotine. Stop using the spray to see if the feelings get better and talk to your health care provider if this happens. You may need to use it less often. You could also have nicotine withdrawal symptoms if your NRT dose is too low.
If you have asthma, allergies, nasal polyps, or sinus problems, your provider may suggest another form of NRT.
Special note: This form of NRT poses a more serious risk to small children and pets because the empty bottles of nasal spray contain enough nicotine to harm them. Do not get the liquid on your skin. If there’s any skin contact, rinse thoroughly with plain water right away. If a bottle breaks or liquid leaks out, put on plastic or rubber gloves to clean it up. Call Poison Control and get emergency help if there’s any question of overdose.
Nicotine inhalers
Inhalers are available only by prescription.
The nicotine inhaler is a thin plastic tube with a nicotine cartridge inside. Unlike other inhalers, which deliver most of the medicine to the lungs, the nicotine inhaler delivers most of the nicotine vapor to the mouth and throat where it’s absorbed into the bloodstream.
Nicotine inhalers are the FDA-approved nicotine replacement method that’s most like smoking a cigarette, which some people trying to quit find helpful. They are not the same as electronic cigarettes, which are not approved by the FDA to help people quit smoking. At this time, inhalers are the most expensive form of NRT available.
How to use the nicotine oral inhaler
You puff on the inhaler and the cartridge sends a pure nicotine vapor into your mouth. You may use up the cartridge all at once over about 20 minutes, or puff on it only a few minutes at a time. The recommended dose is between 4 and 20 cartridges a day, slowly tapering off over 6 months.
Possible side effects of the nicotine inhaler
The most common side effects, especially when first using the inhaler, include:
- Coughing
- Mouth and/or throat irritation
- Runny nose
- Upset stomach
Other side effects are related to nicotine:
- Racing heart
- Nervousness
- Headache
No one has all of the side effects, and some people have none. Some side effects, such as racing heart, may occur because you’ve gotten too much nicotine. Stop using the inhaler to see if the feelings get better and talk to your health care provider if this happens. You may need to use it less often. You could also have nicotine withdrawal symptoms if your NRT dose is too low.
Special note: This form of NRT poses an extra risk to small children and pets because the used cartridges still have enough nicotine in them to cause harm if it gets on skin or mucous membranes (for instance, if licked or touched to the eyes, mouth, or other mucous membrane). Be sure to store and dispose of the cartridges away from children and pets. Call Poison Control and get emergency help if there’s any question of overdose.
Nicotine lozenges
Nicotine lozenges can be bought without a prescription.
The lozenge is available in 2 strengths: 2 mg and 4 mg. The needed dose should be based on how long after waking up a person normally has their first cigarette. So, if you smoke your first cigarette within 30 minutes of waking up, use 4 mg nicotine lozenges. If you smoke your first cigarette more than 30 minutes after waking up, use 2 mg-nicotine lozenges. Some people who are using NRT prefer the lozenge to the gum because its use is less conspicuous.
How to use nicotine lozenges
The recommended dose is 1 lozenge every 1 to 2 hours for 6 weeks, then 1 lozenge every 2 to 4 hours for weeks 7 to 9, and finally, 1 lozenge every 4 to 8 hours for weeks 10 to 12. The lozenge makers also recommend:
- Do not eat or drink for at least 15 minutes before using a lozenge or while using a lozenge. (Some drinks can reduce how well the lozenge works.)
- Do not use more than 1 lozenge at a time and do not use one right after another.
- Suck on the lozenge until it is fully dissolved, about 20 to 30 minutes. Move it from side to side in your mouth. Do not bite or chew it like a hard candy, and don’t swallow it. The nicotine absorbs through the mucous membranes of the mouth.
- Do not use more than 5 lozenges in 6 hours, or more than 20 lozenges per day.
- Stop using the lozenge after 12 weeks. If you still feel you need to use the lozenge, talk to your doctor.
Possible side effects of the nicotine lozenge
- Nausea
- Hiccups
- Sore throat
- Coughing
- Heartburn
- Headache
- Gas
- Trouble sleeping
- Racing heart
Choosing and using the right nicotine replacement therapy for you
No one type of nicotine replacement therapy (NRT) – by itself or in combination – is necessarily any better than another. When choosing the type of NRT you will use, think about which method will best fit your lifestyle and pattern of smoking or using smokeless tobacco. For example, do you want/need something in your mouth or something to keep your hands busy? Are you looking for once-a-day convenience? How urgent are your cravings for nicotine?
Here are some important points to think about as you decide:
- Nicotine gums, lozenges, and inhalers are substitutes you can put into your mouth that let you control your dosage to help keep cravings under better control.
- Nicotine gums and lozenges are generally sugar-free, but if you are diabetic and have any doubts, check with the manufacturer.
- Nicotine nasal spray works very quickly when you need it.
- Nicotine inhalers allow you to mimic the use of cigarettes by puffing and holding the inhaler. It also works very quickly.
- Nicotine patches are convenient and only have to be put on once a day.
- Both inhalers and nasal sprays require a doctor’s prescription.
- Some people may not be able to use patches, inhalers, or nasal sprays because of allergies or other conditions.
- Nicotine gum may stick to dentures or dental work making it hard to chew before “parking.”
Whatever type you use, take your NRT at the recommended dose. NRT is not recommended for long-term use, but if it’s needed to prevent relapse, continuing to use NRT is preferable than returning to smoking.
If you use a different dose or stop taking it too soon, NRT can’t be expected to work like it should. If you smoke very heavily very lightly, or are a smokeless tobacco user, talk with your health care provider about how to get the NRT dose that best fits your needs.
What is light, average, and heavy smoking?
Most nicotine replacement therapy (NRT) products recommendations are based on how much you smoke. But there’s no formal category in any textbook or group that defines how much smoking is considered light, average, or heavy smoking.
These are general guidelines:
- Light smoking: Fewer than 10 cigarettes per day
- Heavy smoking: A pack a day or more
- Average smoking falls in between.
How do I know what NRT dose to use based on my smokeless tobacco use?
NRT products are supposed to roughly match the amount of nicotine you typically took in through tobacco. It can be more of a challenge to get the dose right for smokeless tobacco users, since NRT products are labeled for people who smoke.
Certain types of NRT may help more than others. If you look at the way the tobacco is used, nicotine gum and lozenges are most like using smokeless tobacco. They also let you control your dose to help keep nicotine cravings down. To avoid withdrawal symptoms, you want to aim for a nicotine dose fairly close to what you got from snuff or tobacco use.
These are general guidelines:
- A heavy user is a person who uses more than 3 cans of snuff or 3 pouches of tobacco a week, and would typically use the higher doses of NRT (the dose for people who smoke heavily).
- Those who use 2 to 3 cans or pouches per week would usually try the moderate doses.
- Those who use less than 2 would start with the lowest doses of NRT.
If you’ve decided to try NRT, discuss your dose with a health care provider before you quit tobacco.
Combining the patch and other nicotine replacement products
Using the nicotine patch along with shorter-acting products, like the gum, lozenge, nasal spray, or inhaler, is another method of NRT. The idea is to get a steady dose of nicotine with the patch and then use one of the shorter-acting products when you have strong cravings. In general, people who have smoked heavily do better with this combination approach. If you’re thinking about using more than one NRT product, be sure to talk to your health care provider first.
High-dose nicotine replacement therapy for people who smoke heavily
For people who have been smoking heavily, Another option is to use NRT at a higher than usual dose based on the amount of nicotine that they’ve been getting from cigarettes. At this time, not much is known about this option. High-dose NRT should be considered only with a health care provider’s guidance and close supervision.
Can you get too much nicotine from NRT?
Nicotine overdose is rare, but possible. Nicotine replacement therapy (NRT) products are labeled to match the amount of nicotine you get from NRT to the amount you got from tobacco. If used this way, you should get a nicotine dose fairly close to what you’ve been getting. You don’t want to get more than that, because higher doses of nicotine can cause harm. To avoid this, follow dosing instructions carefully. Also, don’t use heat (like a heating pad or heat lamp) on the skin near your nicotine patch – you could absorb more nicotine due to the increased blood supply.
Nicotine absorbs through the skin and mucous membranes, so you must store and dispose of your NRT safely. Nicotine overdose can be fatal, but this is rare and requires taking in very high doses of nicotine. Overdose is more of a problem in children and pets because of their smaller size. Keep NRT and used gum, patches, empty cartridges, bottles, etc., safely away from children and pets. Never drop them on the street or in open trash cans where kids and animals can reach them.
Symptoms of nicotine overdose
Here are some symptoms of too much nicotine:
- Headache
- Nausea and vomiting
- Belly pain
- Diarrhea
- Agitation, restlessness
- Fast or irregular heartbeat
- Cold sweat
- Pale skin and mouth
- Weakness
- Tremors (shaking)
- Confusion
- Disturbed vision and hearing
- Weakness
- High blood pressure, which then drops
- Dizziness or faintness due to low blood pressure
- Seizures
- Fast breathing in early poisoning, breathing may stop later
Call Poison Control and get emergency help if you suspect an overdose. If you’re taking NRT as prescribed and are still having mild symptoms such as headache, vomiting, diarrhea, or sweating, lower your dose and talk to your health care provider.
Does nicotine cause cancer?
No, nicotine has not been found to cause cancer. While nicotine is the addictive substance in tobacco, it is other compounds in tobacco that can cause cancer. Using NRT to quit tobacco does not increase your risk of cancer – in fact, it can help lower your risk if it helps you stop using tobacco.
Stopping nicotine replacement therapy
Nicotine replacement therapy (NRT) is meant to be used for a limited period of time. Use should be tapered down before NRT is stopped. Studies to date have not shown that extending NRT use longer than the recommended time greatly impacts quit success. However, long-term NRT use is still preferable to smoking.
Research is still being done to refine the use of NRT. If you feel that you need NRT for a different length of time than is recommended, it’s best to discuss this with your health care provider.
Long-term nicotine replacement therapy dependence
Nicotine replacement therapy (NRT) has the potential for long-term dependence. Nicotine is addictive, and people can transfer their dependence from tobacco to the NRT.
Referenced From: Nicotine Replacement Therapy to Help You Quit Tobacco | American Cancer Society