Nicotine Replacement Therapy (NRT)

Factsheet - September 1998

Nicotine replacement products help relieve some of the withdrawal symptoms people experience when they quit smoking. Three nicotine replacement products are currently available over-the-counter in the United States, including two nicotine patches and nicotine gum. Nicotine nasal spray and a nicotine inhaler are available only by prescription. A new non-nicotine pill also is available as a smoking cessation treatment option. To be most effective, nicotine replacement products should be used in conjunction with a behavior change program.  It is necessary with all types of nicotine replacement therapy to follow the doctor's orders and use these products only as prescribed and/or according to labeling.

• It is necessary with all types of nicotine replacement therapy to follow the doctor's orders and use these products only as prescribed and/or according to labeling. These products can also be dangerous for pregnant women.

                       NICOTINE PATCH

• The nicotine patch releases a constant amount of nicotine in the body; the nicotine dissolves right through the skin and enters the body. The patches are similar to adhesive bandages and are available in different shapes and sizes. A larger patch delivers more nicotine through the skin.

• Less nicotine is obtained through the patch than in cigarettes. The patch also does not contain all the tars and poisonous gases that are found in cigarettes.

• Most of the patch products are changed once every 24 hours. One particular patch is worn only during the waking hours and is removed during sleep.

• Studies have shown that it is much easier to give up the patch than it would be to give up cigarettes for two reasons. First, people usually develop cravings for things that provide immediate satisfaction, such as chocolate. With the patch, the nicotine level in the body stays relatively constant day after day. There is not immediate satisfaction, so there is little craving for a patch. Second, anything people do often, such as smoking, becomes a habit; since you apply the patch only once a day, there is no strong habit to break.

• The goal in using nicotine medications is to stop smoking completely. If you plan to take nicotine medications, begin using them on the day you quit. If you continue to have strong urges to smoke or are struggling to stop smoking completely, ask your healthcare provider about additional help.

• Some side effects from wearing the patch can include:
  • headaches
  • dizziness
  • upset stomach
  • weakness
  • blurred vision
  • vivid dreams
  • mild itching and burning on the skin
  • diarrhea

• Wearing the nicotine patch lessens chances of suffering from several of the major smoking withdrawal symptoms such as tenseness, irritability, drowsiness, and lack of concentration.

  NICOTINE GUM

• Nicotine gum contains enough nicotine to reduce the urge to smoke. The over-the-counter gum is available in the same strength as the original prescription product, 2mg (for smokers of 24 or fewer cigarettes each day) and 4mg (for smokers of 25 or more cigarettes each day).

• Like nicotine patches, nicotine gum helps take the edge off cigarette cravings without providing the tars and poisonous gases found in cigarettes. It is a temporary aid that reduces symptoms of nicotine withdrawal after quitting smoking.

• Nicotine gum must be used properly in order to be effective. Steps for nicotine gum users to follow include:

• Stop all smoking when beginning the nicotine gum therapy.

• Do not eat or drink for 15 minutes before using, or while chewing the gum (some beverages can reduce its effectiveness).

• Chew the gum slowly on and off for 30 minutes to release most of the nicotine. Parking the gum between the cheek and gum allows the absorption of nicotine into the lining of the cheek.

• Chew enough gum to reduce withdrawal symptoms (10-15 pieces a day but no more than 30 a day).

• Use the gum every day for about a month or so, then start to reduce the number of pieces you chew a day, chewing only what you need to avoid withdrawal symptoms.

• Discontinue use of gum after three months.

                NICOTINE NASAL SPRAY

• Nicotine nasal spray, dispensed from a pump bottle, relieves cravings for a cigarette. It delivers nicotine to the nasal membranes and reaches the bloodstream faster than any other NRT products. It is available by prescription.

                NICOTINE INHALER

• The nicotine inhaler consists of a plastic cylinder containing a cartridge that delivers nicotine when you puff on it. Although similar in appearance to a cigarette, the inhaler delivers nicotine into the mouth, not the lung, and enters the body much more slowly than the nicotine in cigarettes. The nicotine inhaler is available only by prescription.

               NON-NICOTINE DRUG

• A non-nicotine pill, bupropion hydrochloride (Zyban) was approved in 1997 to help smokers quit. The drug, available by prescription only, is also sold as an antidepressant under the name Wellbutrin.

For more information on quitting smoking call the American Lung Association at 1-800-LUNG-USA (1-800-586-4872), or visit our web site at http://www.lungusa.org.

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