Types of Nicotine Replacement Therapy (Part 1): Nicotine Patches and Gums




Smoking causes two types of addiction: mental and physical. In order to concentrate attention on mental aspect, smokers are offered nicotine replacement therapy (NRT) which gives a little dose of nicotine to the body helping to fight withdrawal symptoms.

Food and Drug Administration has approved five types of NRT: nicotine patches, gum, nasal spray, inhalers and lozenges.

1. Nicotine patch or transdermal nicotine system is the most common type of NRT. It gives a dose of nicotine through skin. With time the nicotine intake is reduced by lower-dose patches gradually eliminating addiction.

The patches are sold with and without prescription and they are very simple to use. A light-to-average smoker can start with a 16-hour patch that is likely not to give any side-effects. A heavier smoker would probably use a 24-hour patch that provides nicotine to the body during day and night. An advantage of this kind is that it helps to fight morning withdrawal symptoms.

According to the package the nicotine patch should be applied in the early morning on a clean, dry area of skin without much hair, below neck and above waist. As a rule people choose upper arm or chest. Food and Drug Administration recommends using it for 3-5 months. In the beginning a full-length patch (15-22 mg of nicotine) should be applied daily for 4 weeks. After that the dose can be reduced to 5-14 mg for another 4 weeks.

Possible side effects are skin irritation, dizziness, racing heartbeat, insomnia or unusual dreams, headache, nausea, vomiting, and muscle aches. They usually occur due to wrong dose of nicotine, very sensitive skin or wrong application. A participant can avoid the side effects if he or she tries a different brand of patch, reduces the dose of nicotine and avoids smoking areas. If the problems cannot be eliminated, one should try a different type of nicotine replacement therapy.

2. Nicotine gum or nicotine polacrilex. It is a fast-acting method which is close to smoking because the nicotine is taken by mouth through mucous membrane the same as with cigarettes. The gums are available to anybody since they are sold in any drug store without prescription.

Depending on nicotine concentration the gum has 2 or 4 mg strength. A heavy smoker that does more than a pack per day, smokes within 30 minutes of waking up time or cannot resist a cigarette in a restricted area should start with a 4 mg gum. It is not allowed to have more than 20 nicotine gum pieces per day which can be used for 1-3 months totally.

The instructions say that nicotine gum should be chewed slowly until peppery taste appears. After that a person can either continue chewing for 20-30 minutes or just “park” the gum inside his or her cheek. Food and drinks affect the absorption of nicotine, so it is not recommended to have acidic food, coffee, juices or soft drinks for at least 15 minutes before and during the gum use.

A big advantage of the gum is that the intake can be controlled or even scheduled. This way one can easily reduce nicotine level. At the same time, a participant might take the gum only when the withdrawal symptoms are too strong and impossible to handle.

However, this kind of NRT has a drawback. Although it is recommended to use the gum for not longer than 6 months, some participants keep coming back to it for a year or longer. Maybe a gum would not bring so much damage to health as cigarettes, but until the ground researches have been made, doctors do not advise using nicotine gum for more than 6 months.

Besides long-term addiction nicotine gum has some side effects: bad taste, hiccups, throat irritation, mouth sores, nausea, jaw discomfort, racing heartbeat. They usually appear if the gum is swallowed or chewed too fast.

Maria White

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Posted on March 19, 2009 
Filed Under How to Quit Smoking, Stop Smoking, Stop Smoking News

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