Nicotine replacement therapy: What you should know


Have you tried to quit smoking without any chemical help, just to resume the bad habit again? There is a place for nicotine replacement therapy (NRT), and according to research, using NRT to help you quit has a greater success rate.

When you try to quit, you will most likely experience withdrawal symptoms and keep on craving cigarettes. Studies show that using nicotine replacement methods, such as medication, patches, gums or lozenges, can double your chances of quitting successfully.

Where to start

With so many options out there, it can be overwhelming to determine which method of nicotine replacement will work best for you. NRT helps with the physical dependence on cigarettes so that you can pay attention to combatting your emotional dependence.

You can start nicotine replacement therapy as soon as you decide to quit, but you can also consult your medical practitioner to determine what will work best for you.

Important to remember

It’s crucial to bear in mind that any NRT product will only reduce physical cravings for nicotine. These products should be used in conjunction with other methods such as behavioural therapy that will help you fight the emotional dependence on cigarettes.

What are my options?

NRT comes in various forms which include the following (all available in South Africa):

  • Patches
  • Gums
  • Inhalers
  • Sprays

Which one should I choose?

With a variety of NRT products out there, it can be a bit daunting to choose the best. Most of these products are available over the counter in South Africa.

Nicotine patches

How it works: These are easy to use and should be stuck on a non-hairy patch of skin first thing in the morning. Nicotine is then gradually released through the skin.

Possible side-effects: Skin irritation, headache, dizziness, racing pulse, disturbed sleep, nausea, vomiting, digestive tract discomfort and stiff or sore muscles. If these symptoms occur, switch to a lower dose patch.

Nicotine gum

How it works: Nicotine gum works fast, as it delivers a dose of nicotine to the bloodstream through the lining of the mouth. The gum is mostly preferred by those who have sensitive skin and are unable to use patches.

Don’t chew this gum continuously as you would chew normal gum – instead, chew it slowly until you feel a tingling sensation and then hold it against the wall of your cheek to release the nicotine into the mouth lining.

Possible side-effects: Dizziness, mouth and throat irritation, mouth ulcers, hiccups, nausea, vomiting, digestive tract discomfort, jaw muscle ache, racing heartbeat and increased salivation. Many of these symptoms are caused by swallowing nicotine or chewing too rapidly.

Nicotine inhalers or sprays

How it works: Nicotine is administered into the mouth via an inhaler pump or spray bottle. This method gives users the opportunity to control the dose of nicotine. The nicotine reaches the bloodstream via the tongue and mouth.

Possible side-effects: Coughing, throat irritation and an upset stomach.

Is it safe to use these products?

While these products contain nicotine to help you wean yourself off cigarettes without going cold turkey, it’s most unlikely that you will remain addicted to nicotine, as levels are too low to cause a dependency. According to a previous Health24 article, using NRT is far safer than smoking cigarettes.

There are limitations on who should use NRT. Pregnant women and those who suffer from cardiovascular disease should avoid using NRT, unless their doctor gives them the go-ahead and smoking cessation is crucial. Recent studies have shown that NRT should be safe for people hospitalised for heart conditions. Consult your doctor if you are unsure.

Don't use NRT if you are still smoking tobacco as the combined doses of nicotine from the cigarettes and NRT could be dangerous, and the NRT will be less effective. Do not use more than one product at the same time.

Image credit: iStock

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