by Why Quit Smoking?
Smoking is highly addictive due to the chemical nicotine. Quitting smoking is one of the best things a person can do for their health. Smoking harms nearly every organ in the body and puts smokers at higher risk for cancer, heart disease, stroke, lung diseases and diabetes. Within 20 minutes of smoking that last cigarette, the body begins a series of changes that continue for years. Blood pressure drops and pulse rate slows. Within 12 hours, carbon monoxide level in the blood drops to normal. Within 2-12 weeks, circulation improves and lung function increases. After 1-9 months, coughing and shortness of breath decrease. Quitting smoking reduces the risk of lung cancer by almost half within 5-10 years of quitting. It cuts the risk of many other smoking related cancers in half within 5-10 years as well.
Nicotine Replacement Therapies
Nicotine replacement therapies (NRTs) provide nicotine to the body in a form that is safer than Smoking Cessation and Nicotine De-addiction Products. This can help manage nicotine cravings and withdrawal symptoms when trying to quit smoking. Common NRTs include nicotine gum, lozenges, patches, inhalers and nasal sprays. Nicotine gum and lozenges release nicotine slowly through the mouth when chewed or dissolved. Skin patches release nicotine through the skin over 16-24 hours providing a consistent nicotine level. Nasal sprays and inhalers mimic the rapid nicotine delivery of smoking. Studies have shown using NRTs can double or triple smoking cessation success rates compared to trying to quit cold turkey without help.
Nicotine Gum
Nicotine gum is a popular NRT option. It comes in 2mg and 4mg strengths. People are advised to chew one piece of gum slowly when craving a cigarette until a slight peppery or minty taste develops, then “park” the gum between gum and cheek. This mimics the hand-to-mouth habit of smoking and provides nicotine, without health risks of smoking. Chewing releases nicotine into the bloodstream through the lining of the mouth within a few minutes. People gradually decrease the number of pieces chewed daily as withdrawal symptoms ease. Nicotine gum is effective when used as directed for 3-6 months. A key with nicotine gum is chewing slowly to extract just the right amount of nicotine without “overdosing”.
Nicotine Lozenges
Nicotine lozenges dissolve slowly in the mouth, releasing nicotine through the lining to enter the bloodstream. They are available in 2mg and 4mg strengths. Lozenges have a similar mechanism of action to gum but may be more convenient as they do not require chewing. Users suck on a lozenge slowly until a peppery or minty taste develops, then “park” between cheek and gum. Lozenges can be used for up to 6 months with the same step down approach as gum. Combining lozenges with gum can be beneficial for some, alternating between them when cravings strike. As with gum, it is important to suck on lozenges slowly to avoid higher than intended nicotine absorption via the mucous membranes in the mouth.
Nicotine Patches
Nicotine patches deliver a consistent dose of nicotine through the skin over 16-24 hours, providing a steady lower level of nicotine compared to smoking. This assists in managing cravings and withdrawal symptoms over a longer period. Patches are available in 21mg, 14mg, and 7mg doses. The 21mg dose is recommended for heavy smokers (30+ cigarettes per day) for the first 6 weeks. The patch is applied once daily usually in the morning on clean, dry, hairless skin on the upper body or arm, and worn for 16 or 24 hours. Common side effects include skin irritation, redness or itching at the application site. Application site should be rotated with each new patch. Patches can be used for up to 10 weeks, gradually reducing dose per the schedule on each box. Combining patches with short-acting NRTs like gum or lozenges enhances success.
Nicotine Inhalers and Sprays
Nicotine inhalers and sprays mimic the hand-to-mouth ritual and rapid nicotine delivery of smoking more closely than other NRTs. Nicotine inhalers have a plastic mouthpiece containing a nicotine-impregnated cartridge that is puffed on like a cigarette. Nicotine nasal sprays are self-administered by spraying a fine mist in each nostril that rapidly delivers nicotine to the brain via capillaries in the nose. This leads to a spike in brain nicotine similar to smoking. Both provide nicotine relief within minutes. Common dosing involves 6-16 cartridges/day for inhalers or 1-2 sprays/nostril when craving starts. Like other short-acting NRTs they can be used for up to 6 months. Inhalers and sprays tend to be slightly less effective than patches and gum/lozenges and should be combined with counseling for best results.
Prescription Medications
Prescription medications can double or triple smoking cessation rates compared to placebo. Three types are available by prescription: varenicline (Chantix), bupropion (Zyban) and nicotine replacement therapies (NRTs). Varenicline partially activates nicotinic receptors in the brain to reduce cravings and withdrawal symptoms, while partially blocking dopamine released by smoking. Bupropion works through mechanisms in the reward pathway of the brain influenced by dopamine and norepinephrine. It is thought to ease withdrawal symptoms and reduce pleasure from smoking. Both varenicline and bupropion are usually taken for 7-12 weeks combined with counseling support. NRT prescriptions can provide doses and formulations not available OTC for those requiring additional nicotine support. Prescription medications work best alongside counseling and when used as directed over at least 7-12 weeks.
Choosing the Right Cessation Product
No single smoking cessation product works best for everyone. Factors to consider include degree of nicotine addiction, smoking habits, past quit attempts, medical conditions and cost/insurance coverage. Combining counseling and two cessation products, such as the patch plus lozenges, often works best by satisfying both nicotine craving and hand-to-mouth habit. It is also important to choose a product with patient support and continue use as directed, usually for at least 3 months up to 6 months. With determination and the right treatment plan, most smokers who try to quit can succeed. Don’t get discouraged by early slips – just resume the program. Perseverance is key in breaking the addiction to cigarettes and improving health.
*Note:
1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it
