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(922 results for Nicotine Replacement Therapy)

Nicotine Replacement Therapy

Nicotine replacement therapy (NRT) is the most commonly used medication for smoking cessation, reducing withdrawal symptoms by providing a small amount of nicotine. The goal of NRT is to cut down on nicotine cravings and ease symptoms of nicotine withdrawal. For some people, using NRT can also help reduce weight gain commonly associated with smoking cessation. NRT options are most effective when people use them in context with smoking cessation programs.

NRT Options: Over-the-Counter

The U.S. Food and Drug Administration first approved nicotine gum and patches as prescription products between 1984 and 1992. NRT gum and patch products transitioned to over-the-counter (OTC) products between 1996 and 2002, based on scientific research showing they were safe for use without a prescription. The nicotine lozenge was approved for OTC use in 2002, followed by the mini-lozenge in 2009.

Nicotine Patch: Several brands are available, all of which work in a similar manner.

– A single patch is worn each day and replaced after 24 hours
– The patch is placed on a hairless area above the waist and below the neck
– Wearing the patch for 24 hours results in fewer withdrawal symptoms
– People who smoke fewer than 10 cigarettes per day should start with a lower dose patch (e.g.14 mg)

Nicotine Gum and Lozenges: Many gum and lozenge brands with similar attributes are available – it is a matter of personal preference. The following tips should be followed to help prevent side effects and improve efficacy.

– Chew nicotine gum slowly until you can taste the nicotine or feel a slight tingling in your mouth. Then stop chewing and place (park) the chewing gum between your cheek and gum. When the tingling is almost gone (about one minute), start chewing again. Repeat this procedure for about 30 minutes.
– If the first cigarette of the day is smoked within 30 minutes of waking up, use the 4-mg gum or lozenge; if more than 30 minutes, use the 2-mg gum or lozenge.
– Weeks 1 to 6 of treatment: Use one lozenge or piece of gum every 1 to 2 hours.
– Weeks 7 to 9: Use one lozenge or piece of gum every 2 to 4 hours.
– Weeks 10 to 12: Use one lozenge or piece of gum every 4 to 8 hours.
– For strong or frequent cravings, chew a second piece within one hour.
– To improve the likelihood of quitting smoking, use at least nine pieces of nicotine gum or lozenges each day for the first six weeks.

Nicotine Inhalers (prescription): This device resembles a cigarette and is especially suitable for people who miss having a cigarette in their hand. Nicotine cartridges are inserted and inhaled in a manner similar to smoking. About 6-12 cartridges a day should be used for eight weeks and then gradually reduced during the next four weeks.

Nicotine Nasal Spray (prescription): This is a pump bottle containing nicotine, placed into the nose and sprayed. This form of NRT closely mimics the rapid increase in nicotine levels obtained from smoking cigarettes and may help relieve sudden cravings.

Precautions and Side Effects

– If you recently had a heart attack or have serious heart problems (e.g. arrhythmia or angina), consult your doctor before using NRT.
– While NRT is a better option than cigarette smoking for pregnant women, most healthcare professionals prefer smoking cessation counseling.
– NRT is not recommended in people younger than 18 because these products have only been tested on adults.
– People with sensitive skin or allergies to adhesive should not use the patch.
– Nicotine gum is not recommended for people who have problems with the jaw joint (e.g. temporomandibular disorders).

The side effects vary by product, however, less than 5% of users reported stopping use of NRT due to side effects.

Patch: Skin rash, insomnia and vivid dreams
Gum: Bad taste, tingling tongue, nausea, heartburn, hiccups and jaw pain
Lozenges: Upset stomach, heartburn, hiccups, headache and excessive gas (flatulence)
Inhaler: Cough, scratchy throat and upset stomach
Nose spray: Peppery feeling in the back of the nose or throat, runny nose, throat irritation, watering eyes, sneezing and coughing

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More on Nicotine Replacement Therapy

Nicotine replacement therapy (NRT) is the most commonly used medication for smoking cessation, reducing withdrawal symptoms by providing a small amount of nicotine. The goal of NRT is to cut down on nicotine cravings and ease symptoms of nicotine withdrawal. For some people, using NRT can also help reduce weight gain commonly associated with smoking cessation. NRT options are most effective when people use them in context with smoking cessation programs.

NRT Options: Over-the-Counter

The U.S. Food and Drug Administration first approved nicotine gum and patches as prescription products between 1984 and 1992. NRT gum and patch products transitioned to over-the-counter (OTC) products between 1996 and 2002, based on scientific research showing they were safe for use without a prescription. The nicotine lozenge was approved for OTC use in 2002, followed by the mini-lozenge in 2009.

Nicotine Patch: Several brands are available, all of which work in a similar manner.

– A single patch is worn each day and replaced after 24 hours
– The patch is placed on a hairless area above the waist and below the neck
– Wearing the patch for 24 hours results in fewer withdrawal symptoms
– People who smoke fewer than 10 cigarettes per day should start with a lower dose patch (e.g.14 mg)

Nicotine Gum and Lozenges: Many gum and lozenge brands with similar attributes are available – it is a matter of personal preference. The following tips should be followed to help prevent side effects and improve efficacy.

– Chew nicotine gum slowly until you can taste the nicotine or feel a slight tingling in your mouth. Then stop chewing and place (park) the chewing gum between your cheek and gum. When the tingling is almost gone (about one minute), start chewing again. Repeat this procedure for about 30 minutes.
– If the first cigarette of the day is smoked within 30 minutes of waking up, use the 4-mg gum or lozenge; if more than 30 minutes, use the 2-mg gum or lozenge.
– Weeks 1 to 6 of treatment: Use one lozenge or piece of gum every 1 to 2 hours.
– Weeks 7 to 9: Use one lozenge or piece of gum every 2 to 4 hours.
– Weeks 10 to 12: Use one lozenge or piece of gum every 4 to 8 hours.
– For strong or frequent cravings, chew a second piece within one hour.
– To improve the likelihood of quitting smoking, use at least nine pieces of nicotine gum or lozenges each day for the first six weeks.

Nicotine Inhalers (prescription): This device resembles a cigarette and is especially suitable for people who miss having a cigarette in their hand. Nicotine cartridges are inserted and inhaled in a manner similar to smoking. About 6-12 cartridges a day should be used for eight weeks and then gradually reduced during the next four weeks.

Nicotine Nasal Spray (prescription): This is a pump bottle containing nicotine, placed into the nose and sprayed. This form of NRT closely mimics the rapid increase in nicotine levels obtained from smoking cigarettes and may help relieve sudden cravings.

Precautions and Side Effects

– If you recently had a heart attack or have serious heart problems (e.g. arrhythmia or angina), consult your doctor before using NRT.
– While NRT is a better option than cigarette smoking for pregnant women, most healthcare professionals prefer smoking cessation counseling.
– NRT is not recommended in people younger than 18 because these products have only been tested on adults.
– People with sensitive skin or allergies to adhesive should not use the patch.
– Nicotine gum is not recommended for people who have problems with the jaw joint (e.g. temporomandibular disorders).

The side effects vary by product, however, less than 5% of users reported stopping use of NRT due to side effects.

Patch: Skin rash, insomnia and vivid dreams
Gum: Bad taste, tingling tongue, nausea, heartburn, hiccups and jaw pain
Lozenges: Upset stomach, heartburn, hiccups, headache and excessive gas (flatulence)
Inhaler: Cough, scratchy throat and upset stomach
Nose spray: Peppery feeling in the back of the nose or throat, runny nose, throat irritation, watering eyes, sneezing and coughing

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