Smoking Cessation Drugs: Nicotine Replacement Products
Type of Medication:
Medications and Their Commonly Used Brand Names
|Type of medication||Brand name|
|Nicotine patch/transdermal nicotine||
|Nicotine nasal spray||Nicotrol NS|
|Nicotine inhaler||Nicotrol Inhaler|
What They Are Prescribed For
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.
How Nicotine Replacement Products Work
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. Here's how each product works:
- The nicotine patch releases nicotine through your skin and into your bloodstream.
- Nicotine gum is chewed slowly, and then stored between the gum and cheek so that the nicotine can be absorbed through the lining of your mouth and into your bloodstream.
- Nicotine lozenges are allowed to dissolve slowly in your mouth to release nicotine at a slow rate.
- Nicotine nasal spray contains small doses of nicotine that are sprayed into your nasal passages and absorbed into your bloodstream.
- A nicotine inhaler contains nicotine that is inhaled through the mouth and is absorbed in the mouth and throat.
Sometimes these products are used in combination, like the patch along with the lozenges, which may help some people stay smoke-free.
Precautions While Taking These Medicines
Do Not Smoke
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 an additional strategy to quit.
See Your Doctor
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.
Do Not Overuse These Products
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:
- Nicotine patch—Do not use longer than 6-12 weeks.
- Nicotine gum—Do not chew or use more than 24 pieces a day; do not use longer than 12 weeks.
- Nicotine lozenges—Do not use more than 20 lozenges a day; do not use longer than 12 weeks.
- Nicotine nasal spray—Do not use longer than 12 weeks.
- Nicotine inhaler—Do not use longer than 12 weeks.
If You Are Pregnant or Breastfeeding, Talk to Your Doctor
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.
Be Careful Around Children
Children can be seriously harmed by any amount of nicotine. Keep these products, including used patches, away from children.
Use With Adolescents and Older Adults
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.
Manage Your Medications
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.
Be Cautious With Certain Conditions
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:
- Asthma or other breathing problems
- Common cold or a stuffy nose
- Dental problems
- Type 1 diabetes
- Heart or blood vessel disease
- High blood pressure
- Swelling of mouth, throat, or esophagus
- Skin irritation or disorder
- Liver disease
- Nose polyps
- Overactive thyroid
- Sinus problems
- Stomach ulcer
- Recent stroke
- Temporomandibular joint disorder
Possible Side Effects
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.
Symptoms of Nicotine Overdose
It is possible to overdose on nicotine when you use nicotine replacement products. Some symptoms of an overdose include:
- Nausea and/or vomiting
- Increased watering of the mouth
- Abdominal pain
- Disturbed hearing and vision
- Difficulty breathing
Smoking Cessation Success
Your chance of long-term success depends a great deal on your motivation and commitment to quitting, regardless of which therapy you choose.
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Last reviewed March 2017 by Michael Woods, MD, FAAP Last Updated: 3/24/2015