Nicotine replacement
Type of medication | Brand name |
---|---|
Nicotine patch/transdermal nicotine |
Habitrol
NicoDerm CQ Nicotrol ProStep |
Nicotine gum/lozenges | Nicorette/Commit |
Nicotine nasal spray | Nicotrol NS |
Nicotine inhaler | Nicotrol Inhaler |
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.
These products provide nicotine without the cigarette, and help to wean your body off of nicotine. The typical effects of withdrawal are minimized as your body adjusts to not smoking and progressively lower doses of nicotine, until the use of the nicotine replacement product is stopped completely.
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 a new strategy to quit.
A recent study showed use of nicotine replacement product before the actual quit day could be beneficial. Talk to your doctor to find out if the strategy is safe for you. * ¹
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.
It may be appropriate for some people to continue using nicotine replacement products longer than the recommended duration. Some people continue to use them for 12 months or longer. Weaning off the medication is encouraged, but continuing on the nicotine replacement medication is preferable to smoking because cigarette smoke contains so many harmful chemicals besides nicotine.
If you are pregnant, planning on becoming pregnant, or breastfeeding, talk to your doctor so she can help you find a safe method to quit smoking. Ask if nicotine replacement products are a good option for you. *²
Children can be seriously harmed by any amount of nicotine. Keep these products, including used patches, away from children.
Nicotine replacement products are believed to be safe for adolescents and older adults. People with dentures, though, should avoid using nicotine gums.
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. The following are especially important for your doctor to know about:
The presence of other medical conditions may affect the use of nicotine replacement products. Tell your doctor if you have any other medical problems, especially the following:
The side effects listed here have been reported for at least one of the nicotine products, not necessarily all of them. However, since many of the side effects of nicotine products are similar, it is possible that these side effects may occur with any one of these medicines, although they may be more common with some than with others.
Contact your doctor as soon as possible if any of the following side effects occur.
These side effects are considered more common:
These effects are considered less common:
Contact your doctor immediately if you experience any of these symptoms (which will probably occur in this order):
Check with your doctor if any of the following side effects occur frequently and/or become bothersome:
It is clear from all of the studies on smoking cessation that your chances of long-term success depend a great deal on your motivation and commitment to quitting, regardless of which therapy you choose.
CANADIAN RESOURCES:
Health Canada
http://www.hc-sc.gc.ca/index_e.html
Healthy Living Unit
http://www.phac-aspc.gc.ca/pau-uap/fitness/
References:
Fiore MC, Jaen CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service. May 2008.
Nicotine substitutes/nicotine replacement therapy. American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=4615. Accessed May 24, 2009.
Online guide to quitting smoking. Smokefree.gov website. Available at: http://www.smokefree.gov/quit-smoking/medicines.html . Accessed May 24, 2009.
* ¹ 10/14/2008 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Shiffman S, Ferguson SG. Nicotine patch therapy prior to quitting smoking: a meta-analysis. Addiction. 2008;103:557-563.
* ² 12/16/2008 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Strandberg-Larsen K, Tinggaard M, Nybo Andersen AM, Olsen J, Gronbaek M. Use of nicotine replacement therapy during pregnancy and stillbirth: a cohort study. BJOG. 2008;115:1405-1410.
Last reviewed May 2009 by Janet H. Greenhut, MD, MPH
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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