Types of Nicotine Replacement Therapy
There are many different types of NRT products - here is an overview of the various therapies available:
Nicotine Gum
Two strengths are available - 2mg and 4mg. You should use the 4mg strength if you smoke 18 or more cigarettes a day. You need about 12-15 pieces of gum per day to start with (about one per hour). To release the nicotine, chew the gum slowly until the taste is strong. Then rest it between the cheek and the gum to allow absorption of nicotine into the bloodstream. Chew the gum again when the taste fades, and rest it again when the taste is strong, etc. Use a fresh piece of gum after about an hour. After 2-3 months you should use the gum less and less. For example, reduce the chewing time, cut the gum into smaller pieces, or alternate the nicotine gum with sugar-free Gradually stop the gum completely. The disadvantage of gum is that some people do not like the taste, or always having something in their mouth. Gum is not suitable if you wear dentures.
Nicotine Patches
A patch that is stuck onto the skin releases nicotine into the bloodstream. Some patches last 16 hours, which you wear only when you are awake. Other types last 24 hours, and you wear these the whole time. The 24 hour patch may disturb sleep, but is thought to help with early morning craving for nicotine.
Patches are discreet, and easy to apply. The patches come in different strengths. The manufacturers normally recommend that you gradually reduce the strength of the patch over time before stopping completely. However, some research studies suggest that stopping abruptly is probably just as good without the need to gradually reduce the dose.
The disadvantage of patches is that a steady amount of nicotine is delivered. This does not mimic the alternate high and low levels of nicotine when you smoke, or with chewing nicotine gum. Skin irritation beneath the patch occurs in some users.
Nicotine Inhaler
This resembles a cigarette. Nicotine cartridges are inserted into it, and inhaled in an action similar to smoking. Each cartridge provides up to three 20 minute sessions. You should use about 6-12 cartridges a day for eight weeks, and then gradually reduce over four further weeks. It is particularly suitable if you miss the hand-to-mouth movements of smoking.
Nicotine Tablets / Lozenges
You dissolve these under the tongue (they are not swallowed). Nicotine is absorbed through the mouth into the bloodstream. They are easy to use.
Nicotine Nasal Spray
The nicotine in the spray is rapidly absorbed into the bloodstream from the nose. This form of NRT most closely mimics the rapid increase in nicotine level that you get from smoking cigarettes. This may help to relieve sudden surges of craving. Side-effects such as nose and throat irritation, coughing, and watering eyes occur in about 1 in 3 users. As the nasal spray may cause sneezing and watering eyes for a short time after use, do not use it whilst driving.
