Nicotine replacement therapy
Nicotine replacement therapy (NRT) reduces the impact of withdrawal symptoms by delivering constant low doses of nicotine. NRT is now widely available either via your GP or over the counter at pharmacies and supermarkets.
NRT does not replace the need for will power but, used correctly, it can double the chances of quitting successfully. If you’ve used it before and gone back to smoking, don’t be put off. Whether you use NRT or not, relapse is common and most smokers will have tried several times before succeeding.
It might also be that you need to find the right type of NRT and the right strength for you. Speak to your stop smoking service, GP or pharmacist if you need help.
NRT comes in different forms to suit different needs. Choosing the right one for you will depend on what aspect of stopping smoking you are finding hardest to deal with.
Some people miss handling cigarettes so an inhalator may be best. Some smokers want to be able to choose when to dose themselves with nicotine; lozenges or gum might be the best option. For heavier smokers, a nasal spray might be the best choice.
Talk through all the options with your pharmacist to find a type that suits you. If one NRT product doesn't work for you, don't give up – discuss other options with your pharmacist.
Find the answers to your questions about NRT below, and read about how each type works.
Patches
Patches are easy to use and can be worn beneath your clothes.
They deliver a steady dose of nicotine into your blood through the skin.
It takes about four to eight hours to reach peak level depending on the
patch you use; some types are for 24 hour use and will deliver a steady
dose, while others should be applied first thing every morning and removed
before bed.
Patch should be applied to a dry, hairless area of skin on the front or
side of the chest, upper arm or hip. The skin can become irritated if the
patch is placed on the same area of skin for two consecutive days.
Gum
NRT gum is not like ordinary chewing gum. There is a technique that needs to be adopted to get the most out of the gum, so that any nicotine that is swallowed is not 'wasted'. It's important to chew the gum gently until the flavour can be tasted, and then 'park' the gum in the cheek so that the nicotine is absorbed through the lining of the mouth.
People generally use 10 to 15 pieces of gum each day for the first three months and then reduce the number of pieces. Heavier smokers can start with the full strength 4mg, reducing to the low strength 2mg gum during the reduction stage.
The taste of NRT gum can be unpleasant at first but most people get used to it with regular use.
Inhalator
An inhalator could suit those who feel they need something to do with their hands when giving up smoking.
The inhalator is a plastic mouthpiece with a replaceable nicotine cartridge inside, which is sucked on like a cigarette. Unlike cigarettes, inhalators don’t deliver a ‘hit’, but they can help with cravings by releasing nicotine which is absorbed through the lining of your mouth.
Nasal spray
The nasal spray is the strongest form of NRT available and is absorbed faster than other forms of NRT, making it ideal for heavy smokers who experience cravings even with gums or patches.
The nasal spray contains a small bottle of nicotine solution, with metered doses sending nicotine directly into the nose in short sprays (this may require practice).
Some people find the spray irritates the nose.
Microtab
This is a small white tablet which is placed under the tongue (it should not be chewed or swallowed). As it dissolves the nicotine is absorbed through the lining of the mouth.
Lozenge
Lozenges come in 2mg and 4mg strengths. The stronger lozenge is designed for those who normally smoke within 30 minutes of waking in the morning.
Lozenges are taken every hour or two for the first six weeks, gradually reducing over the following six weeks.
Frequently asked questions
Why replace nicotine from cigarettes with nicotine in NRT?
Nicotine is the powerful chemical in cigarettes that keeps you addicted to smoking. It only takes seven seconds to reach your brain when inhaled from a cigarette and becomes addictive very quickly.
However, nicotine in cigarettes is not what kills people (that's the tar and carbon monoxide, and many other nasty chemicals found in cigarette smoke).
NRT can help wean you off the addiction and keep you safe from the really dangerous substances found in cigarettes.
Isn't NRT dangerous?
NRT, when used as directed, is a safe and effective way to control nicotine cravings while you quit smoking. NRT contains a smaller amount of nicotine than you would get from a cigarette and is a safe way to make cravings more bearable.
However, it is a medicine, so you should always talk to your GP or pharmacist before using NRT.
How does NRT work?
Nicotine is what keeps you addicted to smoking and causes cravings while you’re trying to quit. When you smoke you take in a ‘hit’ of nicotine that quickly satisfies your craving. This ‘hit’ wears off very quickly making you want to smoke more to get more nicotine.
However, NRT delivers a smaller dose of nicotine to your body over a longer period of time, with the steady, long lasting delivery of nicotine helping to manage the cravings.
Can anyone use NRT products?
There aren't many smokers who can't use NRT products since they’re already taking large quantities of nicotine in their cigarettes.
However if you’re pregnant, under 18 or suffer from a heart condition you should talk to your doctor first. If you suffer from a medical condition or are taking medication, you should also speak to your doctor or pharmacist first.
In almost every case using NRT will be a much safer option than continuing to smoke.
NRT is expensive. Can’t I just use NRT when I think I need it most?
Don't try to save money by seeing how long you can last between gum or puffs on your inhalator, by cutting patches in half or by stopping use of NRT early. Irregular use means your nicotine levels won't be steady, which could make your cravings come back or even get worse. It's important to complete the whole course to ensure you are properly weaned off nicotine.
For the best results you need to use the right amount of the right NRT product for the right length of time. Follow the instructions on the package and ask your pharmacist if you need more information.
Get an appointment with your GP, or speak to a stop smoking service to get your NRT on prescription.
If you don’t have a prescription then a week's supply of patches or gum will cost between £13 and £20 depending on the brand and strength, which is still a lot cheaper than smoking for many smokers.
Can't find an answer here? Email enquiries@nosmokingday.org.uk