Nicotine Replacement Therapy for Quitting Tobacco

What To Think About

If you slip or smoke a little, don't give up. Talk to someone who has quit smoking or to a counselor, to get ideas for what to do. If you are taking medicines or using nicotine replacement, keep doing so unless you go back to regular smoking. Using nicotine medicines and smoking rarely causes you to use too much nicotine. Symptoms of too much nicotine are headaches, nausea, confusion, and vomiting. If you think you have overdosed, call your doctor right away.

Regardless of the method you use to quit smoking, you may cough more or start coughing for the first week after you quit. This is not a symptom of withdrawal from nicotine. It is the result of your body trying to clear your lungs. This happens whether you use nicotine replacement therapy or not.

With nicotine gum, lozenges, and the inhaler, not taking enough each day is a common cause of relapse.

Avoid drinking beverages, especially acidic beverages (such as coffee, juices, and soda pop) for 15 minutes before and after you use these products. Your body may not absorb the nicotine well because of the acid in these drinks.

Choosing a form of nicotine replacement therapy is usually a matter of personal choice. If you smoke more than 20 cigarettes a day, or you smoke within 30 minutes of waking up in the morning, use the highest dose of a product, whether it is gum, lozenges, the patch, or a combination of NRT.

The U.S. Food and Drug Administration (FDA) says it's okay to start using a nicotine replacement product on your quit date, even if you aren't able to stop smoking right away.

If you find you cannot continue to use one form of nicotine replacement because of its side effects, stop using that form and try a different one. Remember, using nicotine replacement products doubles your chances of quitting smoking.^{footnote 1}

Long-term use of nicotine gum has not been found to be harmful.

Nicotine replacement therapy will reduce most but not all of the nicotine withdrawal, craving, and other symptoms associated with quitting smoking.

By the time you finish nicotine replacement therapy, you will have greatly decreased your dependence on nicotine. You also will have started to get used to not smoking at the usual times. This will take longer for people who have smoked for many years. And it may mean using nicotine replacement products for several weeks or months. Stopping nicotine replacement therapy too early is a common cause of relapse. When you finally reduce your nicotine intake to zero, you still may have some symptoms of nicotine withdrawal. But these symptoms won't last. Using nicotine replacement products makes symptoms less severe.

Talk to your doctor before you use two forms of nicotine replacement (such as a nicotine patch and nicotine gum) at the same time.

Using bupropion and nicotine replacement products together may work well for some people who smoke. But it should be tried only under a doctor's care. Your doctor may recommend bupropion alone instead of using two medicines.

Nicotine nasal spray (Nicotrol) is a prescription medicine that delivers more nicotine but often causes side effects. It is not widely used.

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