Nicotine Replacement Therapy – NRT
By Smokefree Team
This page provides details of NRT, why we use it and how it’s used.
Nicotine is the main addictive chemical in cigarettes, without nicotine we wouldn’t smoke. It’s the nicotine or rather lack of it that causes a smoker to experience withdrawal symptoms when stopping smoking. Tobacco also contains many thousands of chemical of which many cause cancer or are poisonous to our bodies.
NRT is a clean, safe form of nicotine. This means your brain gets the nicotine it craves, without all of the nasty chemicals making stopping smoking easier. As the nicotine in NRT is absorbed more slowly than the nicotine in tobacco smoke, it is easier to come off of NRT than tobacco.
Patches are placed on the skin and deliver a steady supply of nicotine through the skin into your bloodstream. When stopping smoking, they help keep your blood-nicotine levels more steady therefore reducing your cravings. Patches come in 16hr or 24hr variants, with each variant having a high, medium or low strength.
We’d generally recommend a 24hr patch if you smoke during the night or if you find it particularly to resist smoking within the first 30 minutes of waking up at the start of your day.
However, it is recommended that patches should be used with a second NRT product. We will discuss these products below.
Nicotine gum is not used like ordinary chewing gum, instead you simply chew the gum for a few seconds until it becomes soft and chewy, then ‘park’ it between the gums and cheek. The nicotine will be absorbed through the lining of your mouth. After the taste starts to fade, give it another chew to reactivate, then ‘park’ it again. Repeat this process for about half an hour. If you just chew it like normal chewing gum, you will swallow most of the nicotine which will reduce its ability to cure cravings. you can use up to 15 pieces of gum per day.
There are many types of nicotine lozenges available. Some are around the size of a 1p coin (although) thicker and some are around a third of this size. There are various strengths 1mg, 1.5mg, 2mg and 4mg and many different brands however they all work in the same way, essentially allowing the nicotine to be absorbed through the lining of the mouth. Lozenges are sucked until they dissolve with a maximum daily dosage of 15 per day.
The mouth spray comes in 1mg strength, providing a quick, and effective dose of nicotine within 60 seconds. Some people find it best to spray the gum into the cheek or under the tongue rather than straight to the back of your throat, then wait a few seconds before swallowing to allow the nicotine to be absorbed through the lining of the mouth. If after a minute, you are still craving, you can have another spray with a recommended daily dose of 64 sprays a day.
The nasal spray is also very quick acting and powerful at taking cravings away. Place the tip inside the nostril, then spray, DO NOT inhale as you would with a decongestion spray. Each spray delivery 0.5mg of nicotine, so a spray in each nostril will deliver 1mg. It may make your nose run afterwards so keep a tissue to hand.
The inhalator is a white tube that contains replaceable cartridges consisting of a small plastic cylinder in which there is a small sponge containing nicotine. The inhalator does not have a battery and is not like a vape, It does not produce a cloud of vapour like vapes. Unlike vapes, the nicotine vapour is not inhaled into your lungs, instead it is just inhaled into the mouth. The inhalator does not provide the same level of nicotine as a cigarette so you will use it for longer than a cigarette, puffing on it more to reach sufficient levels of nicotine. You can use up to 6 cartridges per day.
The sublingual tablets are small tablets that are placed under the tongue and left to gently dissolve. They take about 30 minutes dissolve, heavy smokers (More than 20 a day) can use up to 2 tablets per hour up to a maximum daily dose of 40 a day.