nicotine replacement therapies nicotine replacement therapies

nicotine replacement therapies

They really do work!

Good news! Nicotine Replacement Therapy has been proven to double a person’s chances of quitting. This success rate is further enhanced when you combine nicotine replacement therapy with counselling or a support program like that from the Smokers’ Helpline.

To increase your chances of success, give us a call. Your Helpline counsellor will be able to help you get started on your quit plan, answer any questions you have about nicotine replacement products, and help you find the right support (phone counselling, e-counselling, or support groups).

How Nicotine Replacement Therapy works

With nicotine replacement therapy (NRT), the nicotine you would normally get by smoking cigarettes is delivered into your bloodstream using other safer methods. In Canada, the authorized forms of nicotine delivery include the nicotine patch, gum, lozenges, mouth sprays and inhalers.NRT products work by reducing your nicotine cravings and relieving some of the unpleasant symptoms of nicotine withdrawal you may experience when you quit smoking. They aren’t a magic cure; you’ll still need determination and will-power to quit, but we hear every day from our Helpline callers that the products do really make it easier.

All the above NRT products are available without a prescription and are proven to be safe when used properly. Though they contain nicotine, they do not contain the over 4.000 other harmful chemicals found in tobacco smoke. There is also no evidence that they cause nicotine addiction, cancer or the other serious health effects associated with smoking.

Though nicotine replacement therapy is safe, there are some people who shouldn’t use nicotine replacement therapy (pregnant women, people with cardiovascular disease). Be sure to talk to your doctor or pharmacist first.

To learn more, click on the products below to learn how they are used.

Nicotine Patch

The patch helps to lower cravings for cigarettes by supplying a constant level of nicotine to the blood stream through the skin. As your brain gets used to the steady supply of nicotine, you’ll become less dependent on cigarettes. Then you slowly lower your dose (3 steps) to become less dependent on the nicotine.Consider using this product if you:

  • Are a moderate to heavy smoker (smoking 20 cigarettes or more per day).
  • Would prefer to have sustained and consistent levels of nicotine over 24 hours.
  • Don’t want to have to take a nicotine product throughout the day; you just put it on in the morning and you’re set!
  • Would like to conceal use of your smoking cessation aid. No one can even tell that you’re using the patch!

How it’s used:

  • The patch is attached to the skin like a bandage. You apply a new patch daily onto a dry, non-hairy spot of skin such as the upper arm or chest.
  • The patch must be used properly to be effective. Consult the instructions that are included in the package when you purchase the patch.
  • There are patches that are meant to be worn for 24 hours and those that can be removed at night (16 hours).
  • Cutting a patch in half will make it ineffective.

Dosage:

  • Available in Canada in different dosages and different brands. Dosages come in three levels – 21 mg (Step 1), 14 mg (Step 2), and 7 mg (Step 3).
  • Those who smoke 20 cigarettes or more per day should begin the treatment program on Step 1, and generally stay on each level of the patch for 3-4 weeks.
  • Those who smoke less than 20 cigarettes per day should begin using Step 2, and use it for 6-8 weeks before stepping down to Step 3.

Duration:

  • People typically use patch therapy for 3 months. Some people may wish to use the patch longer than three months, which is still safer than relapsing to smoking. A common error is to quit the patch sooner than recommended.

Watch out for:

  • Possible side effects may include headache, insomnia, dizziness, anxiety, irritability, fatigue, stomach upset and diarrhea. Some of these effects may be nicotine withdrawal symptoms or may be caused by the nicotine in the patch. Your dose may need to be adjusted.
  • It is normal to experience mild itching, burning, or tingling when you first apply a patch, but this should disappear within an hour. If the skin under the patch becomes swollen or red, or if you develop a rash, remove the patch and call your health care provider.

Nicotine Gum

Chewing on nicotine gum will give you an immediate hit of nicotine. The nicotine is released by contact with saliva and absorbed through the lining of the mouth.You can buy nicotine gum over the counter without a prescription. It comes in 2 mg and 4 mg strengths.

Consider using this product if you:

  • Prefer to have control over how much nicotine you are getting and when you are getting it. You can use it as needed rather than receiving a constant supply.
  • Enjoy chewing gum.
  • Want to replace the action of taking out a cigarette, and putting something in your mouth. If you have a craving, you reach for a piece of gum instead of reaching for a cigarette.

How it’s used:

  • In order to be effective, the gum must be used properly. Rather than chewing it continuously, the gum should be chewed slowly until you can taste the nicotine or feel a slight tingling in your mouth. You then stop chewing and place (park) the gum between your cheek and gum. This will allow the nicotine to be absorbed. When the tingling is almost gone (about 1 minute), start chewing again. This “chew, chew, park” process should be repeated for about 30 minutes.
  • Do not drink coffee, soft drinks or other beverages while chewing as this will prevent the absorption.

Dosage:

  • Available in 2 different strengths: 2 mg and 4 mg.
  • Generally, the 2 mg gum should be used if the person smokes less than 25 cigarettes per day, and the 4 mg gum should be used if the person smokes 25 or more cigarettes per day.
  • Individuals may chew 10 to 15 pieces of gum daily.

Duration:

  • Most people use the gum for approximately 3 months. Heavy smokers may need to use it longer.

Watch Out For:

  • The most common side effects are burning throat, hiccups, or dental problems. These symptoms can often be eliminated if the gum is chewed properly.

Nicotine Lozenges

Lozenges are taken when you have a craving. They dissolve in your mouth, releasing nicotine which gets quickly absorbed into the bloodstream.Consider using this product if you:

  • Prefer to have control over how much nicotine you are getting and when you are getting it. You can use it as needed rather than receiving a constant supply.
  • Want to replace the action of taking out a cigarette and putting something in your mouth. If you have a craving, you reach for a lozenge instead of reaching for a cigarette.

How it’s used:

  • The lozenge should be placed in the mouth and allowed to dissolve slowly; it should not be chewed or swallowed. A warm or tingling sensation may be felt as the nicotine is absorbed in the mouth.
  • Occasionally shift the lozenge from one side of the mouth to the other.
  • Each lozenge lasts about 20-30 minutes before it is dissolved completely.
  • Avoid eating or drinking 15 minutes before using the product or while it is in the mouth.

Dosage:

  • Available in 2 different strengths: 2 mg and 4 mg.
  • If you usually smoke your first cigarette within the first 30 minutes after waking, you should use the 4 mg lozenge. If you usually wait at least 30 minutes after waking before smoking your first cigarette, you should use the 2 mg lozenge.
  • Normally individuals begin by using 1 lozenge every 1-2 hours during weeks 1-6, then reduce to 1 lozenge every 2-4 hours during weeks 7- 9, then 1 lozenge every 4-8 hours for the remainder of treatment.
  • Generally, 20 lozenges per day is the maximum.

Duration:

  • Generally used for a period of 12 weeks.

Watch out for:

  • Mouth, throat or tongue irritation; nausea, stomach upset, headaches, hiccups, taste change

Nicotine Inhaler

The nicotine inhaler looks like a fat, plastic cigarette with a mouthpiece. When you take a puff from the inhaler, the cartridge inside releases a nicotine vapour; the nicotine is then absorbed into the bloodstream via the mouth. This delivery method is the one that’s closest to smoking a cigarette, which is why some smokers prefer this method.Consider using this product if you:

  • Prefer to have control over how much nicotine you are getting and when you are getting it. You can use it as needed rather than receiving a constant supply.
  • Want to replace the action of putting something in your mouth. If you have a craving, you can take a puff from the inhaler instead of a puff from a cigarette.

How it’s used:

  • A person breathes in nicotine-filled air through the mouthpiece and refills the nicotine cartridge as needed.
  • Each nicotine cartridge lasts for approximately 20 minutes of active puffing. You get about 30% of the nicotine found in a cigarette which helps to lessen the craving for cigarettes.
  • Try different puffing ‘schedules’ to help control cravings. For example, puffing on the inhaler for 5 minutes at a time means that it will last for 4 uses; puffing on it for 10 minutes at a time means that it will last for 2 uses.
  • Avoid drinking acidic beverages such as coffee, tea, soft drinks, alcohol or citrus juices as they can prevent the nicotine from being absorbed.

Dosage:

  • Each cartridge holds 10 mg, however not all of the nicotine in the cartridge gets absorbed by the user.
  • The recommended dosage is 6-12 cartridges per day for the first 12 weeks. If you need to continue with the therapy, the number of cartridges per day should be reduced over the next 6-12 weeks.

Duration:

  • Up to 6 months if needed.

Watch out for:

  • Possible side effects include mouth and throat irritation from the nicotine. This usually goes away or lessens as people adjust their use of the product.

Nicotine Mouth Spray

With nicotine mouth spray, you spray once or twice into your mouth when you are having a craving. The nicotine is absorbed quickly into your bloodstream.Consider using this product if you:

  • Prefer to have control over how much nicotine you are getting and when you are getting it. You can use it as needed rather than receiving a constant supply.
  • Want to replace the action of taking out a cigarette and putting something in your mouth. If you have a craving, you reach for the mouth spray instead of reaching for a cigarette.

How it’s used:

  • Point the dispenser as close as you can to your open mouth. Avoiding your lips, press down firmly on the dispenser to release a spray into your mouth. Don’t spray it in the back of your throat and avoid inhaling.
  • Hold the spray in your mouth for few seconds before swallowing.
  • Wait a few minutes; if you are still having a craving, you can spray again. If you find that 2 helped, have 2 consecutive sprays each subsequent time.

Dosage:

  • Each spray is 0.07 ml and contains 1 mg of nicotine.
  • A mouth spray dispenser has at least 150 sprays.
  • Most smokers will require 1-2 sprays every 30 minutes to 1 hour.
  • You should only have up to 4 sprays per hour. Do not use more than 2 sprays at a time or 64 sprays (4 sprays per hour over 16 hours) in any 24-hour period.

Duration:

  • Generally used for a period of 12 weeks.

Watch out for:

  • Some users have reported a mild burning sensation on their lips if they come into contact with the spray. This is completely normal and nothing to worry about. To avoid, simply take care not to get any spray on your lips.

For more information about these products, talk to your health care provider or call the Smokers’ Helpline: 1-800-363-5864