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Nicotine replacement therapy: Questions answered

Once you've decided to quit, the next move can be a bit overwhelming. There are heaps of options and methods out there. How do you decide what's best? And what do all the terms and acronyms mean? We're here to clear things up.

Some people worry about whether it’s safe to use nicotine replacement therapy (NRT) products like the patches, gum, lozenges, Inhalator or mouth spray. We answer some common questions below.

1) How does nicotine replacement therapy (NRT) work? 

As you probably know, cigarettes are highly addictive. It’s because they contain a chemical called nicotine. When you puff on a cigarette, it takes just seconds for nicotine to go from the lungs to the brain.

If you’ve been a smoker, your brain is filled with nicotine receptors. These receptors eagerly await incoming nicotine. Think of nicotine as a key, and receptors as little locks. When the nicotine unlocks the nicotine receptor, a feel-good chemical called dopamine is released, giving you a little hit or buzz. This doesn’t last long. The nicotine soon fades making the receptor eager for more. Cue a cigarette craving!

NRT provides you with a little bit of nicotine, which locks on to some (but not all) of your nicotine receptors. To put it simply, NRT lessens cravings.

NRT products such as mouth spraygum, lozenges, and Inhalator, give you nicotine within a few minutes that can help you get past short, strong cravings. 

Nicotine patches provide a slow, steady level of nicotine over a long period. 

The best chance of success comes from using what’s called combination therapy: patches PLUS a fast-acting form of NRT (mouth spray, lozenge, gum or Inhalator). That way you have a steady level of nicotine for the day PLUS a bit extra at times when you would normally smoke. If you pair an NRT product or combination therapy with a call to Quitline, you further increase your chance of quitting for good. 

2)  Can I get addicted to NRT products? 

It is unlikely that you will become addicted to NRT because the amount of nicotine in them is low. Also, compared to a cigarette, it takes longer for nicotine to get to the brain and to give you a nicotine hit. 

A small number of people have told us they’ve become addicted to nicotine mouth spray, lozenge or gum. You might like to see this as “clean nicotine”, free from the thousands of damaging chemicals in cigarettes. In short, using an NRT is much safer than smoking. It’s also much easier to quit NRT compared to a cigarette. 

3) Is NRT dangerous?

NRT products have to pass strict safety standards set by the Therapeutic Goods Administration (TGA) before they can be sold in Australia. NRT has been used safely, around the world, for many years. 

4) What about side-effects?

It’s actually quite rare to get side effects if you use NRT as directed. However, if you don't use the products correctly, it can cause some problems. For example, if you keep chewing the gum without resting it, or you chew or swallow a lozenge, it can upset your stomach. If you point the spray at the back of your throat instead of under your tongue, it can irritate your throat and give you a coughing fit. 

Also, quitting smoking is hard. The resulting feelings and nicotine withdrawals can be uncomfortable. Sometimes these discomforts are mistaken for an NRT product side effect. For example, having trouble sleeping is can be from nicotine withdrawal but sometimes it is mistakenly linked to NRT products. Also, when you take in less nicotine, you absorb more caffeine from coffee, tea, cola or chocolate. This can make you feel restless and unsettled. 

5) What happens if I have a smoke while I’m wearing a patch?

You don’t need to take the patch off if you have a cigarette. It’s actually best to leave it on. Slip-ups – a puff or a cigarette during a quit attempt – are common. But it doesn't mean you should stop trying to quit. Treat it as an opportunity to understand what situations make you want to smoke. Plan for next time. 

If you have returned to your previous smoking, put the patches away until you’re ready to try quitting again. 

For more questions about NRT, call Quitline or request a Quitline callback.

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