Nicotine Replacement Therapy to Quit Smoking

There are many pharmacological approaches to smoking cessation but the most popular include nicotine replacement treatment (NRT) and anti-smoking medications.

Nicotine Replacement Therapy

There are four main nicotine replacement products available including nicotine gum, transdermal patch (nicotine patch), nasal spray, and vapor inhalant.

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  • Nicotine Gum. The gum delivers the nicotine rapidly through the mucous membrane of the mouth. Nicotine gum is available over the counter and can be purchased at most pharmacies or drug stores.
  • Transdermal patch. Also called a nicotine patch, this approach provides a consistent dose of nicotine through the skin and can be titrated down to lower and lower doses as the physical dependence diminishes. Certain nicotine doses are available over the counter.
  • Nasal spray. The nasal spray delivers nicotine to the bloodstream rapidly as the nicotine is absorbed through the nose. It is available only by prescription.
  • Nicotine Inhalers. The nicotine inhaler is a thin plastic tube (like a cigarette) with a cartridge inside. The nicotine inhaler delivers most of the nicotine vapor to mouth (not to the lungs) and mimics smoking behavior.

Nicotine replacement products are designed to provide nicotine without the other harmful chemicals present in tobacco. This approach helps manage the physical dependence on cigarettes (which is caused by the nicotine) and prevent or reduce withdrawal symptoms after stopping smoking.

Nicotine replacement therapy deals only with the physical symptoms of withdrawal and is not meant to be the only method to quitting smoking. It is best when combined with other psychological methods as reviewed previously. Studies have demonstrated that nicotine replacement combined with a program designed to change behavior doubles one’s chances of successfully quitting smoking.

References

  • 1.Glassman, S.D., Anagnost, S.C. et al. (2000). Theeffect of cigarette smoking and smoking cessation on spinal fusion. Spine, 25, 2608-2615.
  • 2.Glassman, S.D., Dimar, J.R. et al. (2007). The efficacy of rhBMP-2 for posterolateral lumbar fusion in smokers. Spine, 32, 1693-1698.
  • 3.Ho, M.K. and Tyndale, R.F. (2007). Overview of the pharmacogenomics of cigarette smoking. The Pharmacogenomics Journal, 7, 81-98.
  • 4.Patkar, A.A., Vergare, M.J. et al. (2003). Tobacco smoking: Current concepts in etiology and treatment. Psychiatry, 66, 183-199.
  • 5.Ranny, L., Melvin, C. et al. (2006).  Systematic review: Smoking cessation interventions strategies for adults and adults in special populations. Annals of Internal Medicine, 145, 845-856.
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