Nicotine Substitutes: What to Expect

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Nicotine Substitutes: What to Expect

From the American Cancer Society



If you're hooked on nicotine or if you've tried quitting before, think about using nicotine replacement therapy. This method gives you a small dose of nicotine to help cut down the urge to use tobacco once you quit. Nicotine gum, lozenges, and "the patch" are sold over the counter at your drug store. Other forms of nicotine replacement, such as nasal sprays and inhalers, need a doctor's prescription. Nicotine replacement therapy costs about the same as a pack of cigarettes per day. You will only have to use replacement therapy for a short period of time.

How Nicotine Replacement Works

Nicotine substitutes treat the very difficult withdrawal symptoms and cravings that 70% to 90% of smokers say is their only reason for not giving up cigarettes. By using a nicotine substitute, a smoker's withdrawal symptoms are reduced.

While a large number of smokers are able to quit smoking without nicotine replacement, most of those who attempt quitting are not successful on the first try. In fact, smokers usually need several attempts before they are able to quit for good.

Lack of success is often related to the onset of withdrawal symptoms. By reducing these symptoms with the use of nicotine replacement therapy, smokers who want to quit have a better chance of being successful.

For smokers, nicotine blood levels will vary, depending on individual smoking patterns such as the time between cigarettes, how deeply the person inhales, the number of cigarettes smoked per day, and the brand smoked. Smoking delivers nicotine to the bloodstream very quickly - within a few seconds. Nicotine replacements generally work more slowly, and the amount of nicotine in the bloodstream is less than that from smoking.

Getting the Most from Nicotine Replacement

Nicotine replacement therapy only deals with the physical aspects of addiction. It is not intended to be the only method used to help you quit smoking. It should be combined with other smoking cessation methods that address the psychological component of smoking, such as a stop smoking program. Studies have shown that an approach - pairing nicotine replacement with a program that helps to change behavior - can double your chances of successfully quitting.

The US Agency for Healthcare Research and Quality (AHRQ) Clinical Practice Guideline on Smoking Cessation recommends nicotine replacement therapy for all smokers except pregnant women and people with heart or circulatory diseases. If a health care provider suggests nicotine replacement for people in these groups, the benefits of smoking cessation must outweigh the potential health risk.

The most effective time to start nicotine replacement is at the beginning of an attempt to quit. Often smokers first try to quit on their own, then decide to try nicotine replacement. Nicotine replacement therapy should not be used if you plan to continue to smoke or use another tobacco product. The combined dose of nicotine could be dangerous to your health.

Smokers who are pregnant or have heart disease should consult with their doctor before using over the counter nicotine replacement.