Nicotine Replacement Therapy: How to Quit the Cravings

What is nicotine replacement therapy?

Nicotine replacement therapy works by delivering a dose of nicotine, without the harmful chemicals that come with cigarettes. NRT most commonly comes in the form of patches, gum, sprays, inhalators, and lozenges (more on those later).

People who have smoked for a while develop a complicated relationship with nicotine. Nicotine can trigger a lot of positive experiences in the brain including attention, memory, cognitive processing, and a dose of the feel-good chemical, dopamine. Your brain translates this as a good thing, and once the nicotine wears off (often after hours or even minutes), it starts craving more.

Unfortunately, cigarettes and other tobacco products contain a whole lot of other chemicals that, as we know, are doing bad things for your health and wellbeing.

Retraining the brain to kick this habit can be a challenge, especially in the first few days when nicotine cravings are the strongest. That’s why smokers who quit without a nicotine-exit plan are more likely to relapse than others. In fact, research shows that it can take 30 or more quit attempts before ongoing success.

A reason for this is often due to experiencing symptoms of withdrawal; intense cravings, irritability, insomnia, and mood disturbances. These can all stem from the receptors in your brain complaining when they don’t get that wonderful nicotine buzz.

Thankfully the worst of these symptoms are short-lived and peak for just two to three days. Nicotine replacement can be a helpful tool to get you through those first days and weeks. Next, we’ll look at how it helps.

How does nicotine replacement therapy work?

NRT works by releasing therapeutic amounts of nicotine into the bloodstream without the added chemicals in cigarettes, such as tar, lead, ammonia, and carbon monoxide.

The regulated doses of nicotine help to control the difficult cravings and keep you feeling as comfortable as possible, helping you to minimize any withdrawal symptoms. While NRT is a great way to effectively quit smoking, your success rate also relies on determination and willpower to keep going.

Forms of NRT can be used in combination with one another. For example, a long-lasting, slow-release skin patch can be perfectly paired with an instantaneous burst of nicotine from gum, lozenges, sprays, or an inhalator. The majority of smokers who use combination therapy have a much higher chance of successfully quitting, typically doubling the success rate.

Please speak to your healthcare provider for more information on NRT and for personalized recommendations on the use of combination therapy.

Types of nicotine replacement therapy

As mentioned previously, the most common forms of NRT that you will come across include transdermal patches, gum, lozenges, inhalators, and sprays.

‍Transdermal Patches: These are applied to the skin and deliver a dose of nicotine directly to the body. The patches come in a variety of strengths to address the different levels of nicotine dependence between heavy smokers and lower-dependency smokers. Over a series of weeks or months (time frames vary from person to person), the strength of patches can be decreased to slowly wean you off nicotine. Studies show that long-term usage of patches is a safe and effective way to maintain tobacco abstinence if required.

‍Gum: Nicotine gum, as the name suggests, is a fast-acting chewing gum that helps to reduce cravings by replacing some of the nicotine your body is used to absorbing. The gum comes in both 2mg and 4mg, so please seek advice from your doctor or pharmacist on the correct dosage for your circumstance. The usage is typically recommended for 8 weeks, or as directed by your healthcare provider.

Nicotine gum is not like regular gum and should be used as follows:

1. When a craving strikes or you think one may be approaching, reach for that gum!
2. Chew the gum until you start to notice a tingling sensation in your mouth. Put the gum underneath your tongue or in your cheek (this is known as ‘parking’), and resume chewing when the tingling stops.
3. Repeat this for 30 minutes or until the gum loses flavor, and your craving dissipates.

‍Lozenges: Another common form of NRT, the lozenge, is used very similarly to nicotine gum. When you feel a craving, or anticipate one, pop a lozenge in your mouth and roll it around with your tongue until it dissolves. Do not suck, chew, or swallow the lozenge whole. All up, the lozenge should dissolve within 15-20 minutes.

‍Sprays: Depending on your preference, you can choose from a nasal or oral spray. This is a fast-acting approach to addressing cravings and the nicotine is rapidly absorbed into the bloodstream. Research suggests that nicotine oral sprays can achieve better results than that of a nicotine lozenge.

‍Inhalators: Nicotine inhalators are ideal for those with a behavioral attachment to smoking. This form of NRT targets the ‘hand-to-month’ action by imitating the movement of smoking a cigarette. The inhalator is equipped with a cartridge and mouthpiece that delivers nicotine into the bloodstream by inhaling.

What are the side effects of nicotine replacement therapy?

It is uncommon to experience serious side effects from NRT, which is why most types are available over-the-counter and without a prescription.

However, there are some frustrating, yet manageable and mild side effects that you may experience while using NRT. Most discomfort is found in and around the direct area, such as skin irritation from using a patch, or mouth ulcers from oral sprays.

Some other side effects to look out for include:

• Heart palpitations
• Nausea and/or vomiting
• Indigestion or GI complaints
• Hiccups
• Coughing
• Dizziness
• Insomnia
• Muscle aches and pains

If you experience symptoms that you find to be unmanageable and disruptive, please speak with your healthcare provider directly.

Can you use nicotine replacement therapy with other quit methods?

Using NRT and other quit methods can double the chances of successfully quitting, so yes!

As mentioned above, using a slow-release patch in conjunction with a nicotine spray, lozenge, gum, or inhalator is recommended by professionals and can keep your cravings at bay. It’s important to address your reasons for smoking, too. Is it a way to soothe yourself from emotional responses like stress and anxiety? Do you live with or work closely with heavy smokers who normalize the habit? Whatever the cause, it’s important to address the situation head-on and make changes that best support your intentions to quit. You should always be your number one priority, so make the effort to put your health and well-being first.

Alongside typical NRT, there are other quit methods that you can implement for extra support on top of your existing nicotine exit plan. For example, hypnotherapy programs, such as Finito, have been designed by experts to support all areas of your quit journey: cravings, the reasons why you smoke, and help you build new habits to replace the role of cigarettes in your life.

‍The Wrap Up

NRT can be an effective way to support you on your journey to quitting smoking for good. There are a variety of types available for you to choose from, including skin patches and gum, that help to keep your nicotine cravings at bay. With the support of NRT, healthcare providers, family members, friends, and other quit methods, you will be on your way to tobacco abstinence in no time. Remember, using NRT in conjunction with other forms of exit plans can double the chances of quitting successfully!

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