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Nicotine Replacement Therapy (NRT)

Mohommed Essop-Adam
Reviewed by Mohommed Essop-AdamReviewed on 30.10.2023 | 5 minutes read
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So, you’re thinking about quitting smoking? Great! You’ve made the first step, but what method of quitting is best for you? How can nicotine products help? The reduce-to-quit method involves gradually reducing the number of cigarettes smoked daily before quitting. This method can be supplemented with nicotine replacement products as an alternative to cigarettes to control cravings without the added tar and harmful chemicals.

The choice is to quit entirely or ‘cold turkey’ – this method has the added benefit of feeling the effects of quitting on day one, such as feeling more energetic, but it tests your willpower greatly. This is the reason the reduce-to-quit method is recommended first line. Nicotine replacement therapy (NRT) comes in various forms to suit individual lifestyles and smoking habits. Different long-acting or short-acting nicotine products keep cravings at bay or fix sudden urges that are brought on.

Long-acting Nicotine

Long-acting nicotine is not a form of nicotine but rather a type of formulation which covers underlying cravings throughout the day. The main form of products come as patches.

It releases a steady stream of nicotine into the bloodstream regularly throughout the day to control the baseline cravings. This may be used alone, alongside avoidance of triggers and willpower or may be supplemented with other nicotine replacement products that act quickly. This will not cover breakthrough cravings, which is why it is handy to have short-acting nicotine as well.

Short-acting Nicotine

Short-acting nicotine products come in various forms: gum, lozenge, oral spray, inhalator, and nasal spray. Inhalators are helpful for individuals who miss hand-to-mouth behaviour. Oral and nasal sprays act the quickest and are best to nip cravings in the bud. Gum and lozenges provide longer periods of relief as they can be sucked or chewed over time. However, with all NRT preparations, it depends on what works best for you.

Here is a breakdown of the different short-acting NRTs and their benefits to help you make an informed decision:

Nicotine Gum

When to Use

Nicotine gum is a suitable option for individuals who prefer a flexible dosing schedule and the oral satisfaction of chewing. It's particularly useful for managing sudden cravings throughout the day.

Advantages

  • Provides rapid nicotine absorption through the oral mucosa, offering quick relief from cravings.
  • Allows for flexible dosing based on the intensity of cravings.
  • Mimics the oral fixation associated with smoking, making it a familiar replacement.

Considerations

  • Some people may find the taste or texture of the gum unpleasant.
  • Chewing gum incorrectly (e.g., chewing too quickly or too slowly) can result in improper nicotine absorption.

Nicotine Lozenges

When to Use

Nicotine lozenges are suitable for individuals who prefer a discreet, portable form of NRT that doesn't require chewing. They're particularly helpful for managing cravings in situations where chewing gum may not be appropriate.

Advantages

  • Provides rapid nicotine absorption through the oral mucosa, offering quick relief from cravings.
  • Discreet and portable, allowing for use in various settings.
  • Doesn't require chewing, making it suitable for individuals with dental issues or those who dislike gum.

Considerations

  • Some individuals may find the taste or texture of the lozenge unpleasant.
  • It's essential to follow dosing instructions carefully to avoid consuming too many lozenges in a short period.

Nicotine Oral Spray

When to Use

Nicotine oral spray is suitable for individuals who require rapid relief from cravings or prefer a spray-based delivery method. It's particularly helpful for managing strong cravings or situations where discreet use is necessary.

Advantages

  • Provides rapid nicotine absorption through the oral mucosa, offering quick relief from cravings.
  • Allows for precise dosing control, with each spray delivering a predetermined amount of nicotine.
  • Portable and discreet, it is suitable for use in various settings.

Considerations

  • Some people may experience irritation or a burning sensation in the mouth or throat when using the spray.
  • It's essential to avoid spraying directly onto the back of the throat to minimize irritation.

Nicotine Inhalator

When to Use

Nicotine inhalators are suitable for individuals who miss the hand-to-mouth action of smoking or prefer a more tactile form of NRT. They're particularly helpful for managing oral cravings and providing a smoking-like experience without the harmful effects of tobacco.

Advantages

  • Mimics the hand-to-mouth action of smoking, providing a familiar experience.
  • Allows for controlled inhalation of nicotine vapour, providing quick relief from cravings.
  • Portable and discreet, suitable for use in various settings.

Considerations

  • Some individuals may find the taste or sensation of the inhalator less satisfying compared to smoking.
  • It's essential to use the inhalator correctly to ensure proper nicotine absorption and effectiveness.

Nicotine Nasal Spray

When to Use

Nicotine nasal spray is suitable for individuals who require rapid relief from cravings or prefer a fast-acting delivery method. It's particularly helpful for managing strong cravings or situations where quick relief is necessary.

Advantages

  • Provides rapid nicotine absorption through the nasal mucosa, offering quick relief from cravings.
  • Allows for precise dosing control, with each spray delivering a predetermined amount of nicotine.
  • Particularly effective for individuals with severe nicotine dependence or heavy smokers.

Considerations

  • Some individuals may experience nasal irritation or a burning sensation when using the spray.
  • It's essential to use the spray correctly and avoid excessive use to minimize potential side effects.

Vaping vs Smoking vs Nicotine Replacement Therapy

E-cigarettes or vapes use a refillable liquid to produce vapour rather than smoke. The vapour still contains nicotine, so it is still addictive, but it is free from harmful tar and carbon monoxide in cigarette smoke. Because of this, E-cigarettes are thought of as safer than cigarettes, but E-cigarettes are not free from harm completely.

E-cigarettes are relatively new to the market, and the full long-term effects on health are still unknown. Studies have shown that ingredients in the base liquid can irritate the airways and cause lung injury. Some ingredients are also carcinogens (causing cancer). While it is not advised to start vaping if you are not currently smoking, vaping is a slightly safer alternative to smoking cigarettes, and evidence shows that vaping can help someone quit smoking for good. The results suggest that in combination with face-to-face support, smokers are twice as likely to quit smoking with vaping rather than with NRT.

The importance of personalised approach and support

When considering NRT or any method to quit smoking, it is crucial to recognize that what works for one person may not work for another. Quitting smoking is a highly individualized journey, and finding the right approach may require some trial and error. Additionally, seeking support is vital for success. Whether it's through counseling, support groups, or utilizing smoking cessation services, having a network of encouragement can significantly increase the chances of quitting for good.

Furthermore, it is important to consult your local healthcare professional who can provide guidance and recommend the most appropriate nicotine replacement products or other cessation methods based on individual needs and preferences. They can also address concerns and provide personalized advice on managing cravings and withdrawal symptoms. Remember, quitting smoking is a challenging but worthwhile endeavor, and with the right support and determination, it is possible to overcome nicotine addiction and lead a healthier, smoke-free life.

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Mohommed Essop-Adam
Reviewed by Mohommed Essop-Adam
Reviewed on 30.10.2023
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