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Nicotine replacement therapy
Smoking cessation - nicotine replacement; Tobacco - nicotine replacement therapy
Nicotine replacement therapy involves the use of products that provide low doses of nicotine but do not contain the toxins found in smoke. The goal of therapy is to relieve cravings for nicotine and ease the symptoms when someone stops using cigarettes and smokeless tobacco.
In general, nicotine replacement therapy benefits moderate-to-heavy smokers (people who smoke more than 15 cigarettes a day) the most.
Facts about using nicotine replacement therapy:
TYPES OF NICOTINE REPLACEMENT THERAPY
Nicotine supplements come in several 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 of nicotine supplements.
Nicotine Patch. All nicotine patches are placed and used in similar ways:
Nicotine Gum or Lozenge. You can buy nicotine gum (Nicorette and others) or lozenges (Commit and others) without a prescription. Some people prefer lozenges to the patch, because they can control the nicotine dosage.
Tips for using the gum:
Nicotine Inhaler. The nicotine inhaler looks like a plastic cigarette holder. The nicotine inhaler requires a prescription in the United States.
Using the inhaler and patch together can be very helpful when quitting.
Nicotine Nasal Spray. The nasal spray satisfies immediate cravings by providing quick doses of nicotine.
SIDE EFFECTS AND RISKS
Any of these nicotine products may cause side effects. Patients using very high doses are more likely to have symptoms. Reducing the dose can prevent these symptoms. Side effects include:
Nicotine patches pose no danger for people with heart or blood circulation problems. However, the unhealthy cholesterol levels (lower HDL levels) caused by smoking do not get better until the nicotine patch is stopped.
Nicotine replacement may not be completely safe in pregnant women, although no real harmful effects have been reported. The unborn children of women who use the patch may have a faster heart rate.
Keep all nicotine products away from children, especially small children. Nicotine is a poison.
American Cancer Society. Guide to Quitting Smoking. January 2011. Accessed February 21, 2011.
Burke MV, Ebbert JO, Hays JT. Treatment of tobacco dependence. Mayo Clin Proc. 2008;83:479-483.
Moore D, Aveyard P, Connock M, Wang D, Fry-Smith A, Barton P. Effectiveness and safety of nicotine replacement therapy assisted reduction to stop smoking: systematic review and meta-analysis. BMJ. 2009;338:b1024.
Hays JT, Ebbert JO, Sood A. Treating tobacco dependence in light of the 2008 US Department of Health and Human Services clinical practice guideline. Mayo Clin Proc. 2009;84:730-735.
Reviewed by:David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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