Nicotine Replacement Theraphy For SMOKERS

Help With Physical Addiction: Nicotine Replacement Therapy and Other Medicines

Nicotine Replacement Therapy

As mentioned earlier, the nicotine in cigarettes leads to actual physical dependence, which can cause unpleasant symptoms when a person tries to quit. Nicotine replacement therapy (NRT) gives you nicotine -- in the form of gums, patches, sprays, inhalers, or lozenges -- but not the other harmful chemicals in tobacco. It can help relieve some of these symptoms so that you can focus on the psychological aspects of quitting.

How Nicotine Replacement Works

Nicotine substitutes treat the difficult withdrawal symptoms and cravings that 70% to 90% of smokers say is their only reason for not giving up cigarettes. Using a nicotine substitute, reduces a smoker's withdrawal symptoms.

Although many smokers can quit smoking without using a nicotine replacement, most of those who attempt quitting cannot do it on the first try. In fact, smokers usually need many tries -- sometimes as many as 8 to 10 -- before they are able to quit for good.

Lack of success is often related to the onset of withdrawal symptoms. And most quitters go back to smoking within the first 3 months of quitting. So don't be discouraged if you start smoking again. Just try to stop again and make your attempt more successful by adding another method or technique to help you quit. Reducing these symptoms with nicotine replacement therapy and a support technique, gives smokers who want to quit have a better chance of quitting and staying quit.

Getting the Most from Nicotine Replacement

Nicotine replacement therapy only deals with the physical addiction. It is not meant to be the only method used to help you quit smoking. You should combine it with other smoking cessation methods that help the psychological (emotional and habitual) components of smoking, such as a stop smoking program. Studies have shown that approach -- pairing NRT with a program that helps to change behavior -- can double your chances of successfully quitting.

The US Agency for Healthcare Research and Quality (AHRQ) Clinical Practice Guideline on Smoking Cessation in 2000 recommended NRT for all smokers except pregnant women and people with heart or circulatory diseases. However, recent data suggests that nicotine replacement (specifically the nicotine patch) can be used safely even in people who have heart or blood vessel (cardiovascular) disease under a doctor's careful monitoring. These studies have found the benefits of quitting smoking outweigh the risks of nicotine replacement therapy in patients with cardiovascular disease. In all situations, the benefits of smoking cessation must outweigh the potential health risks. Smokers who are pregnant should also talk with their doctor before using over-the-counter nicotine replacements.

The best time to start NRT is when you first quit. Many smokers ask if it is possible to start a program of nicotine replacement while you are still smoking. There is some research being done with smokers using NRT while still smoking, but it is still too early to tell if this is dangerous to your health. The most important thing is to make sure that you are not overdosing on nicotine, which can have effects on your heart and blood circulation. It is safest to be under a doctor's care if you wish to try smoking and using NRT while you are tapering down your cigarette use.

Often smokers first try to quit on their own then decide to try NRT. This method does not give you the greatest chance of success, but do not let this discourage you. There are still many options available for quitting smoking and staying quit.

When May I Begin Using NRT?

You may start using nicotine replacement products as soon as you throw away that last cigarette. You do not need to wait a certain period of time to put on the patch or start using the method you have chosen. You should double check this information with the instructions on your chosen method of nicotine replacement, but in general there is no need to wait to start using nicotine replacement.

Some NRT products make their recommendations based on whether you consider yourself a light, regular or heavy smoker. How are these categories determined?

There is no formal category in any textbook or group that defines a light, average, or heavy smoker. You will find different definitions for these categories. In general, a light smoker is someone who smokes less than 10 cigarettes per day. Someone who smokes a pack a day or more would be considered a heavy smoker.

Sometimes a doctor will use the term pack year to describe how long and how much a person has smoked. A pack year is defined as the number of packs of cigarettes a person has smoked every day multiplied by the number of years he or she has smoked. Since 1 pack is 20 cigarettes, a person who has smoked 20 cigarettes a day for a year is considered to have smoked 1 pack year. Someone who has smoked 30 cigarettes a day (1½ packs) for 3 years has smoked 4.5 pack years (1½ x 3), and so on.