Nicotine replacement therapy (NRT) is a treatment to help people stop smoking. It uses products that supply low dose of nicotine. These products do not contain many of the toxins found in smoke. The goal of the therapy is to cut down on cravings for nicotine and ease the symptoms of Nicotine Withdrawal.

Types of NRT are:

1. LONG ACTING NRT:

Transdermal Patch

* Frequency: Wear for 24 hrs at a time. Use alternate sites to minimize skin irritation.

* Dose: If consuming less than 10 cigarettes per day, start with 14mg/day. If consuming more than 10 cigarettes per day, start with 21mg/day. Taper down the doses later on.

* Side effects: Vivid dreams, contact dermatitis

2. SHORT ACTING NRT:

Mini lozenge

Can be combined with patch for best effect.

Allow to dissolve slowly. Do not chew or swallow lozenge.

* Dose: 2mg/hr for patients who smoke their first cigarette in MORE than 30 min after waking up. 4mg/hr for patients who smoke their first cigarette in LESS than 30 min after waking up.

* Frequency: Every 1-2hour. Try not to wait for cravings & consume it before craving occurs.

GUM

Combine with nicotine patch for best effects. Chew minimally, just ‘park’ between teeth & cheek. Rechew when tingling is gone & rotate sites in mouth. Avoid use with acidic foods

*Dose: 2mg/hr for patients who smoke their 1st cigarette in MORE than 30 min after awakening. 4mg/hr for patient who smoke their 1st cigarette in LESS than 30 min after awakening.

*Frequency: Every 1-2hr. Try not to wait for cravings.

*Side effect: Gastrointestinal irrigation when chewed.

Nasal Spray

Combine with nicotine patch for best results.

* Frequency: Can be used once to each nostril every 1-2 hr.

*Side effects: Can cause nostril irritation

Inhaler

Take short puffs but keep air in mouth. Do not inhale.

CONCLUSION

No single NRT is most effective for all smokers. Combination of NRT effectively increases smoking cessation rates by about 150-200%

Some are available without prescription and some are available only with prescription. NRT is generally considered safe for most healthy adults , but it’s a good idea to talk to your doctor about the potential risk & benefits.