Nicotine Replacement Therapy
How is nicotine gum used?
You'll use this starting on your quit date, and you'll use it as often during the day as you need to to control your nicotine withdrawal symptoms. That means some people will chew three pieces a day, some six, some twelve pieces a day. You use as many as you need so that you are not having withdrawal symptoms, and you keep that under control. You'll continue this for six weeks, or twelve weeks, slowly decreasing the number of pieces that you use a day, once you've quit smoking, and felt comfortable, and then eventually taper yourself off.
What are the most common side effects associated with nicotine gum?
Nicotine gum, when it is chewed too fast, makes a little more nicotine go down the throat rather than just be absorbed in the mouth, and it can cause irritation, hiccups, and heartburn; so you don't want to over chew the gum. It can also cause irritation to the mouth, which could cause blisters in the mouth. Most people, which is the vast majority of people who use the nicotine gum, get used to the sensation in the mouth and it doesn't cause very untoward effects. Most people tolerate it pretty well.
What is a 'nicotine patch'?
A nicotine transdermal (meaning "going through the skin") patch delivers nicotine for a continuous level 24 hours a day. It takes about two hours to reach that effect, and then once you pull it off, it will take about 30 to 45 minutes for the nicotine levels to start diminishing. So we recommend that you put a patch on when you're ready to quit smoking. Because of this continuous level, there should be enough nicotine in that patch to satisfy the need in your brain for a cigarette, so that it basically extinguishes the withdrawal symptoms, makes someone feel OK. But it will never feel quite as good a cigarette, which gives a really high level with every puff that goes into the lungs and up the carotid arteries quickly to the brain. It will never feel like a cigarette, but it will keep you from having withdrawal.
How is a nicotine patch used?
You put one on when you quit and change it every 24 hours, putting it on a new location. Your upper arms, your upper chest or your upper back. Never put it on the same location twice if there's redness or irritation. If you find itching, burning, tingling or blistering, make sure that you call your doctor and ask them what to do because you may actually be allergic to the adhesive, you aren't allergic to the nicotine.
Are there any limits on who can use a nicotine patch to quit smoking?
People who have problems using the patch, number one, are people who can't tolerate it with their skin. If you have itching, blisters, extreme redness, and your skin just can't tolerate it, that's one. But that's usually an adhesive problem. There's two or three different kinds, so try another company's product and you may tolerate that better. The other people who can't use the nicotine patch are people who get too many side effects from it. If they get nausea, if they can't sleep at night, some people just have to take the patch off at night, keep it on during the day. If you have recently had a heart attack in the last few days to a few weeks and you think you need to quit smoking, you had better get your doctor's advise. I wouldn't just put a nicotine patch on without finding out if that would be appropriate for you, so that there wouldn't be any unnecessary stimulation of nicotine to the chemistry of your heart electrical system.
What are the most common side effects caused by using the patch to quit smoking?
The nicotine patch sends nicotine through the skin, into the blood vessels that are underneath the dermas; the skin. Some people can't tolerate that. It either causes pain at the site, it can cause blistering, redness or irritation; some people's skin is just too sensitive. If some people have eczema or psoriasis, their skin may react badly to the nicotine patch. Some people's side effects include not being able to sleep at night, but that can be fixed by either taking a lower dose – switching to a lower dose patch – or taking the patch off just when you go to bed and then putting it back on in the morning. Some people have similar affects no matter what form of nicotine they use, such as upset stomach, nausea or headaches. In general the nicotine patch, if your skin can tolerate it, is tolerated very well.
How can an inhaler or nasal spray help me quit smoking?
There are multiple ways to get nicotine into someone's brain. You can do it through the skin with a patch. You can do it through the mouth with either the gum, the lozenge, or a nicotine puffer. The puffer, instead of having something you keep inside of your mouth that dissolves, like, gum or a lozenge, is a little gel filled capsule. And, that capsule, you breathe in, so that there's a vapour absorbed in your mouth, or the back of your throat, or your palette. It has nicotine in it, and you can feel the tingling and peppery feeling. It's absorbed exactly the same way as the nicotine gum or the nicotine lozenge. There's another way to get nicotine into your blood system and that is by squirting a spray of it up in your nostrils because the nasal mucous membranes absorb very quickly. And you get a higher absorption rate, and therefore a higher rate of nicotine to your brain by using the nicotine spray. But, both routes, puffing it into the mouth with a nicotine oral inhaler puffer, or through the nasal spray, just delivers nicotine as you need it - when you feel a craving to control withdrawal symptoms throughout the course of the day, based on how your brain is responding to your course of treatment.
What are the most common side effects associated with the nicotine inhaler?
The nicotine inhaler, a puffer, is very similar in its absorption and its side effects to the other agents used in the mouth, such as the nicotine gum and molosome. It can cause irritation, it can cause blistering in the mouth, it can cause hiccups, it can cause an upset stomach, it can cause reflux. But most people find it quite tolerable if they don't mind the flavour, the taste and tingly sensation in the throat. With the puffer, there's more people who say they have a sore throat with it. Often it's because they inhale it or breathe in too deeply.
What are the most common side effects of nicotine replacement nasal spray?
The problems with the nasal spray, because your nose is much more sensitive than your mouth, when you put the nasal spray into your nose you can have reaction in your eyes. Your eyes will water, they'll itch, your nose will itch, you'll sneeze, and it'll drain down the back of your throat and taste bad. It works quickly, so people who really want the nicotine nasal spray to work quickly will get used to those symptoms, and they will diminish over about two to three weeks. It is the quickest way to deliver nicotine.
