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Nicotine replacement therapy

Smoking cessation - nicotine replacement; Tobacco - nicotine replacement therapy

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

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Information

Before you start using a nicotine replacement product, here are some things to know:

TYPES OF NICOTINE REPLACEMENT THERAPY

Nicotine supplements come in many forms:

All of these work well if they are used correctly. People are more likely to use the gum and patches correctly than other forms.

Nicotine patch

You can buy nicotine patches without a prescription. Or, you can have your health care provider prescribe the patch for you.

All nicotine patches are placed and used in similar ways:

Nicotine gum or lozenge

You can buy nicotine gum or lozenges without a prescription. Some people prefer lozenges to the patch, because they can control the nicotine dose.

Tips for using the gum:

Nicotine inhaler

The nicotine inhaler looks like a plastic cigarette holder. It requires a prescription in the United States.

It can help to use the inhaler and patch together when quitting.

Nicotine nasal spray

The nasal spray needs to be prescribed by a provider.

The spray gives a quick dose of nicotine to satisfy a craving you are unable to ignore. Levels of nicotine peak within 5 to 10 minutes after using the spray.

SIDE EFFECTS AND RISKS

All nicotine products may cause side effects. Symptoms are more likely when you use very high doses. Reducing the dose can prevent these symptoms. Side effects include:

SPECIAL CONCERNS

Nicotine patches are OK for use by most people with stable heart or blood circulation problems. But, the unhealthy cholesterol levels (lower HDL level) caused by smoking do not get better until the nicotine patch is stopped.

Nicotine replacement may not be completely safe in pregnant women. The unborn children of women who use the patch may have a faster heart rate.

Keep all nicotine products away from children. Nicotine is a poison.

References

George TP. Nicotine and tobacco. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders;2016:chap 32.

Siu AL; US Preventive Services Task Force. Behavioral and pharmacotherapy interventions for tobacco smoking cessation in adults, including pregnant women: US Preventive Services Task Force recommendation statement. Ann Intern Med. 2015;163(8):622-634. PMID: 26389730 www.ncbi.nlm.nih.gov/pubmed/26389730.

US Food and Drug Administration website. Want to quit smoking? FDA-approved products can help. www.fda.gov/ForConsumers/ConsumerUpdates/ucm198176.htm. Updated December 11, 2017. Accessed February 26, 2019.

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Review Date: 2/6/2019  

Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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