Deciding to quit smoking is the first step to becoming smoke-free, but a decision alone usually is not enough. Most people need help to quit successfully. One of the strongest weapons in the battle against smoking is nicotine replacement therapy.
Tobacco contains nicotine, a powerfully addictive drug. It gives you pleasant sensations that reinforce the urge to smoke. When you quit, you can expect unpleasant withdrawal symptoms. Symptoms usually subside in a few weeks, but they are the main reason people start smoking again.
Nicotine replacement products release small, controlled amounts of nicotine into the body. This helps reduce the cravings that often foil attempts to quit. There is strong evidence to prove that nicotine replacement helps people quit.
You'll have a choice about which type(s) of nicotine replacement therapy to try. This information can help you decide which might be best for you.
Nicotine replacement products: Your options
Nicotine replacement comes in five different forms. All are approved by the U.S. Food and Drug Administration, and they all seem to work equally well. Each has pros and cons that you should consider as you decide which type to try.
Three types can be bought without a prescription: patches, gum and lozenges.
Nicotine patch
Nicotine patches are applied to the skin, often on the upper arm or chest. You start with a full-strength patch for few weeks. Then you switch to a low-dose patch for a few more weeks.
Pros:
- Easy to use - simply placed on the skin once a day
- Can be bought without a prescription
Cons:
- May not be a good choice for people who have skin problems or are allergic to adhesive tape
- May cause side effects such as racing heart, dizziness, headache or vivid dreams
Nicotine gum
Nicotine gum is an easy way to calm cravings. You chew it until you get a peppery taste, then you hold it in your cheek for a while. The nicotine is absorbed through the mucous membranes in your mouth. You alternate chewing and holding for 20 to 30 minutes. Many people chew one or two pieces an hour. Most people use the gum for one to three months.
Pros:
- Fast-acting
- Lets you control the dose - can be increased when cravings are strong
Cons:
- May cause side effects such as bad taste, mouth irritation, nausea or hiccups
- May not be recommended for people with dentures or jaw problems
Nicotine lozenges
Nicotine lozenges are similar to cough drops and work the way nicotine gum does. You hold the lozenge between your cheek and gum and let it dissolve. You use one lozenge every one to two hours for the first six weeks. You gradually taper the dose and then stop after 12 weeks.
Pros:
- Easy and convenient to use
- Gives you control of the dose
Cons:
- Should be used with caution by people with heart rhythm problems or heart disease
- May cause side effects such as sore gums, throat irritation or stomach upset
Two products are available only by prescription: nasal spray and inhalers
Nicotine nasal spray
Nicotine nasal spray comes in a pump bottle. When you have a craving, you spray the nicotine mist into your nose.
Pros:
- Quickest control of symptoms
- May be especially helpful for heavy smokers
Cons:
- Not recommended for people with asthma, allergies or other breathing problems
- May cause side effects such as sneezing, coughing or nasal irritation
Nicotine inhaler
A nicotine inhaler is a plastic tube with a cartridge inside. When you puff on the tube, the cartridge sends nicotine vapor into your mouth. The drug is absorbed in your mouth, not in your lungs. An inhaler is usually used for about 12 weeks at gradually lower doses.
Pros:
- The type of replacement therapy that is most like smoking
- May help those who have trouble giving up the ritual of holding and puffing on a cigarette
Cons:
- Most expensive form of nicotine replacement therapy
- May cause side effects such as coughing, throat irritation and stomach upset
Choosing a product
To choose a nicotine replacement product,think about how the type of nicotine replacement might be best for you.
- Gum or lozenges give you something to chew or suck on.
- An inhaler or nasal spray gives you something to hold.
- A patch provides a level amount of nicotine throughout the day.
Whichever type you choose, it is important to use it as directed for as long as directed. It is less likely to work if you don't use it correctly or stop using it too soon.
Talk to your doctor if you are pregnant or have any long-term health problems before you use any medication. That includes over-the-counter nicotine replacement products.
Facts about nicotine replacement therapy
Keep the following facts in mind:
- Combining nicotine replacement with a quit-smoking program or other support doubles your chance of success. Nicotine replacement helps with the physical cravings, but it doesn't address the emotional aspect of the habit. You're more likely to succeed in quitting if you use nicotine replacement with treatment that helps you change your habits.
- Nicotine replacement therapy reduces withdrawal symptoms, but it may not completely do away with them.
- Be sure you quit smoking before you start nicotine replacement. Otherwise, you may get too much nicotine. This can cause nausea, vomiting, dizziness, diarrhea, weakness or rapid heartbeat.
