Nicotine Replacement Therapies
About Nicotine Replacement Therapies (NRT)
Nicotine Replacement Therapies (NRT) can help you quit your use of tobacco products. The most effective NRTs are The Path and Nicotine Gum.
None of these products has been FDA approved specifically to help people quit smokeless tobacco. This is because it has not been proven how well they work to help quit smokeless tobacco. The results of some small studies have been mixed, and larger studies are needed. Still, NRT may be useful in helping you quit, or at least in helping reduce your cravings.
For smokeless tobacco users, certain types of NRT may help more than others. If you look at the way the tobacco is used, nicotine gum and lozenges are most like using smokeless tobacco. They also let you control your dose to help keep nicotine cravings at bay. The nicotine inhaler may not be as useful for smokeless tobacco users, as it is designed to look and feel like a cigarette filter tip. The nicotine patch gives a steady dose of nicotine, but may not help with strong cravings. Still, the patch may be more useful for people who prefer once-a-day convenience. A 2007 study compared higher-dose nicotine patches with the usual NRT doses in heavy users of smokeless tobacco. The researchers found that higher doses were more helpful in reducing withdrawal symptoms.
NRT products are supposed to roughly match the amount of nicotine you get from NRT to the amount you typically took in through tobacco. It can be more of a challenge to get the dose right for smokeless tobacco users, since NRT products are labeled for smokers.
In general, a person who uses more than 3 cans of snuff or 3 pouches of tobacco a week is thought of as a heavy user, and would typically use the higher doses of NRT (for heavy smokers). Those who use 2 to 3 cans or pouches per week would usually try the moderate doses, and those who use less than 2 would start with the smallest doses of NRT. If you have decided to try NRT, discuss your dose with your doctor before you quit tobacco.
To avoid withdrawal symptoms, you want to aim for a nicotine dose fairly close to what you got from snuff or tobacco use. You don’t want to get much more than that, because high doses of nicotine can cause harm. None of these products has been FDA approved specifically to help people quit smokeless tobacco. This is because it has not been proven how well they work to help quit smokeless tobacco. The results of some small studies have been mixed, and larger studies are needed. Still, NRT may be useful in helping you quit, or at least in helping reduce your cravings.
Nicotine Replacement Therapies
If you would like to speak with someone to assist in choosing the best product for you, you can make an appointment with our ATOD Educator/Counselor or a Health Services clinician.
The Patch helps relieve nicotine withdrawal symptoms by providing a steady dosage of nicotine throughout the day, reducing the individuals craving/urge to smoke.
Using The Patch
- Quit smoking before using The Patch to avoid a tobacco overdose
- Must be kept sealed until ready to be worn
- Apply to a hairless part of the upper body every morning
- Remove old patches before putting new ones on
- Rotate sites each time to avoid skin irritation
- Do not go back to the same site for seven days
- Gradually wean yourself off of nicotine by decreasing the dose
Success rates vary. The patch is meant to help decrease nicotine withdrawal symptoms. It should only be used as a PART of what you do to try to quit smoking. You will also need knowledge, motivation, and coping skills to quit for good.
- More Common: Skin irritation, rash at the site of the patch (notify your practitioner if you have redness after four days or if you have skin swelling), difficulty sleeping.
- Less Common: Nausea, nervousness, diarrhea, rapid heartbeat, aching muscles and joints.
- You can't get "hooked" on The Patch if you use it properly. The patch is used to keep a steady amount of nicotine in your system throughout the day, similar to how nicotine is provided from smoking.
- Always use the patch under medical supervision.
- Do not use patches prescribed to another person.
- Do not share your patches with anyone else.
- Dispose of the patch carefully (keep away from pets and children, it is toxic to them)
The goal of nicotine gum is to keep cravings for cigarettes to a minimum. Nicotine gum releases small amounts of nicotine into the body. It is meant to help curb withdrawal symptoms and to make it easier to conquer nicotine addiction.
Using Nicotine Gum
- Quit smoking before using the gum to avoid a tobacco overdose
- Chew gum only until you notice the slight peppery taste (release of nicotine)
- Place the gum on the inside of your cheek to absorb the nicotine into your body
- Repeat this every 4-5 minutes for 30 minutes, or until you can no longer sense the peppery taste
- Place the gum in a different spot in your mouth each time
Only 5% of all individuals who chew the gum continue using it past the 12 week treatment period. The gum should be used to keep a steady amount of nicotine in your system throughout the day, similar to how nicotine is provided from smoking. The dose of the gum is tapered over a 12 week schedule to reduce the likelihood of becoming dependent.
Here is a schedule to help you determine how much Nicotine Gum you should be using:
1 Piece (1-2 hours)
1 Piece (2-4 hours)
1 Piece (4-8 hours)
Success rates vary. The gum is meant to help decrease nicotine withdrawal symptoms. It should only be used as a PART of what you do to try to quit smoking. You will also need knowledge, motivation, and coping skills to quit for good.
- Sore jaw, sore throat, mouth irritation, heartburn, nausea, rapid heart beat
- Always use the gum under medical supervision
- Do not drink any liquids except water while the gum is in your mouth
- Acidic beverages such as soda and coffee should not be consumed 15 minutes prior to using the gum