Nicotine Replacement Therapies

Nicotine replacement therapy (NRT) refers to a number of quitting aids that ease withdrawal symptoms by delivering nicotine to your body in amounts you can regulate. Over time, you can reduce the nicotine dose, thus weaning your body from the addiction. Using NRT doubles your chances of quitting successfully and permanently. There are five different NRT products available including the patch, gum, nasal spray, inhaler and lozenges.

Below are descriptions of the five NRTs. All are equally effective so you can choose the best NRT for you that will make it easier to quit tobacco. Consult your physician when selecting a NRT. You should begin using your NRT once you quit smoking. Do not use NRT if you plan to continue smoking. If you wish to combine NRT, consult with your physician before making this decision.

Nicotine Lozenges

Nicotine lozenges come in the form of a hard candy and release nicotine as it slowly dissolves in the mouth. Eventually, the quitter will use fewer and fewer lozenges during the 12-week program until he or she is completely nicotine-free.

Biting or chewing the lozenge will cause more nicotine to be swallowed quickly and result in indigestion and/or heartburn.

Nicotine lozenges are available in 2mg or 4mg doses. One lozenge is one dose; maximum dosage should not exceed 20 lozenges per day. Each lozenge will last about 20-30 minutes and nicotine will continue to leach through the lining of the mouth for a short time after the lozenge has disappeared.

Do not eat or drink 15 minutes before using the lozenge or while it is in your mouth.

Nicotine Patch

The nicotine patch is an adhesive square that attaches to your skin, usually the arm. The patch releases nicotine into your bloodstream. Patches are either 16-hour or 24-hour and come in various doses to help the smoker gradually wean off of nicotine.

Nicotine Gum

Nicotine gum release nicotine when chewed. The gum provides a controlled amount of nicotine to your system at a slower, less intense pace than cigarettes. It works as a temporary aid to help you quit smoking by reducing nicotine withdrawal symptoms until your body no longer needs nicotine.

Nicotine Inhaler (prescription only)

The nicotine inhaler consists of a plastic cylinder containing a cartridge that delivers nicotine when you puff on it. Use the inhaler when you have a craving for a cigarette. 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.

Each cartridge delivers up to 400 puffs of nicotine vapor. It takes at least 80 puffs to obtain the equivalent amount of nicotine delivered by one cigarette.

The initial dosage is individualized. The best effect is achieved by frequent, continuous puffing for 20 minutes. One cartridge will last for 20 minutes of continuous puffing and deliver 4 mg of nicotine; only 2 mg are actually absorbed. This is the equivalent of about 2 cigarettes. The maximum suggested dose is 16 cartridges per day.

Nicotine Nasal Spray (prescription only)

Nicotine nasal spray, dispensed from a pump bottle relieves cravings for a cigarette. Nicotine is rapidly absorbed through the nasal membranes and reaches the bloodstream faster than any other NRT product, giving a rapid nicotine "hit". This feature makes it attractive to some highly dependent smokers. A usual single dose is two sprays, one in each nostril. The maximum recommended dose is 5 doses per hour or 40 doses total per day.

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