|Type of medication||Brand name|
|Nicotine patch/transdermal nicotine||
|Nicotine nasal spray||Nicotrol NS|
|Nicotine inhaler||Nicotrol Inhaler|
Nicotine replacement products are used to help people stop smoking. These products work best as part of a program that also includes education, counseling, and/or psychological support.
These products provide nicotine without the cigarette and help to wean your body off of nicotine. The typical effects of withdrawal are reduced as your body adjusts to not smoking. The products provide you with progressively lower doses of nicotine until you stop using them.
Sometimes these products are used in combination, like the patch along with the lozenges, which may help some people stay smoke-free.
Smoking and using nicotine replacement products can be dangerous because nicotine can build up to toxic levels. Since your goal is to quit smoking entirely, you should not smoke while using a nicotine replacement product. If you still have the urge to smoke, you may need a new strategy to quit.
One study showed that the use of a nicotine replacement product before the actual quit day could be beneficial. Talk to your doctor to find out if this strategy is a good approach for you.
Patches, lozenges, and gums can be purchased over-the-counter, but the nasal spray and inhaler require a prescription. Your doctor will help you determine the appropriate dosage. Also, your doctor can prescribe additional smoking cessation aids and can refer you to a counselor, support group, or other services that may help you quit smoking. People who combine several quitting strategies often have the most success.
After quitting smoking, the goal is to end your use of the nicotine replacement products as well. Here are guidelines for how long you should use these products:
If you are pregnant, planning on becoming pregnant, or breastfeeding, talk to your doctor to select a safe method to quit smoking. Ask if nicotine replacement products are a good option for you.
Children can be seriously harmed by any amount of nicotine. Keep these products, including used patches, away from children.
Nicotine replacement products are believed to be safe for adolescents and older adults. People with dentures, though, should avoid using nicotine gum because it could cause damage.
Tell your doctor about all the medications you take. Some should not be taken when you are quitting smoking with nicotine replacement products, while others may require a different dosage level.
The presence of other conditions may affect the use of nicotine replacement products. Tell your doctor if you have any other medical problems, such as:
There are side effects associated with taking nicotine replacement products. The side effects you may experience will depend on the type of product you choose. For example, rash has been associated with using the patch while nasal irritation has been associated with using the nasal spray.
If you experience side effects, talk to your doctor. A different product may be recommended.
It is possible to overdose on nicotine when you use nicotine replacement products. Some symptoms of an overdose include:
Your chance of long-term success depends a great deal on your motivation and commitment to quitting, regardless of which therapy you choose.
American Cancer Society
Canadian Cancer Society
Fiore MC, Jaen CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: US Department of Health and Human Services. Public Health Service. May 2008.
Guide to quit smoking. American Cancer Society website. Available at: http://www.cancer..... Updated January 17, 2013. Accessed March 8, 2013.
Nicotine. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated January 18, 2013. Accessed March 8, 2013.
Nicotine lozenges. Colorado QuitLine website. Available at: https://colorado.q.... Accessed March 8, 2013.
Nicotine replacement & other pharmaceutical therapies. Memorial Sloan-Kettering Cancer Center website. Available at: http://www.mskcc.org/mskcc/html/2553.cfm. Accessed March 8, 2013.
NRTs. Tobacco-Free website. Available at: http://www.tobaccofreeqc.org/quitting/nrts/. Accessed March 8, 2013.
Quit guide. Smokefree.gov website. Available at: http://www.smokefree.gov/qg-index.aspx . Accessed March 8, 2013.
Smokeless tobacco and cancer. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/factsheet/Tobacco/smokeless. Accessed March 8, 2013.
Using the nicotine patch and lozenge to help you stop smoking. University of Wisconsin Heart and Vascular Center website. Available at: https://www.health.... Accessed March 8, 2013.
10/14/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Shiffman S, Ferguson SG. Nicotine patch therapy prior to quitting smoking: a meta-analysis. Addiction. 2008;103:557-563.
12/16/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Strandberg-Larsen K, Tinggaard M, Nybo Andersen AM, Olsen J, Gronbaek M. Use of nicotine replacement therapy during pregnancy and stillbirth: a cohort study. BJOG. 2008;115:1405-1410.
11/13/2009 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
Piper ME, Smith SS, Schlam TR, et al. A randomized placebo-controlled clinical trial of 5 smoking cessation pharmacotherapies.Arch Gen Psychiatry. 2009;66(11):1253-1262.
11/30/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: US Food and Drug Administration. Propoxyphene: withdrawal—risk of cardiac toxicity. US Food and Drug Administration website. Available at: http://www.fda.gov.... Published November 19, 2010. Accessed November 30, 2010.
Last reviewed March 2013 by Brian Randall, MD
Last Updated: 3/12/2013