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Nicotine Replacement Therapy (NRT)

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Nicotine Replacement Therapy (NRT)

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Several different treatments are available to help you quit smoking. One tried and tested tool is Nicotine Replacement Therapy (NRT).

Whether you’ve had unsuccessful attempts in the past or are taking your very first step towards quitting, NRT could help you succeed.

This article will help you to decide if NRT is right for you and what form of NRT will suit you best. Even if you’ve tried an NRT product before that didn’t work for you, there might be another kind that does, so please keep reading.

What is NRT and why use it?

Nicotine is the chemical in tobacco that keeps you coming back for more. Nicotine creates pleasant feelings in the body and mind, but these effects are temporary, so you reach for another cigarette. Once you quit smoking, it is common to experience withdrawal symptoms, which can include irritability, anxiety, headaches or fatigue, normally lasting around 12 weeks.

NRT is a medication that gives your body a low level of nicotine, without the tar, carbon monoxide and 7,000 other chemicals present in tobacco smoke. It can help relieve and reduce withdrawal symptoms and satisfy cravings when they strike.

Nicotine addiction is often not the only thing making it difficult for you to quit smoking, but by dealing with this key issue you can greatly increase your chance of quitting successfully.

What NRT options are available and how to use them?

NRT is available in many forms including patches, inhalators, chewing gum, nasal and mouth sprays, and lozenges.

Patches

Discreet patches worn on the skin which provide sustained levels of nicotine for up to 24 hours a day. One patch is used at a time and applied to any hair-free, dry patch of skin, on a different area of your body each day.

There are two different types of patches available:

16 hour daytime patches
A nicotine patch that is applied when you wake-up and taken off at bedtime.

Available in three strengths: 25mg, 15mg and 10mg.
If smoking 10 or more cigarettes per day, start on 25mg patch.
If smoking less than 10 cigarettes per day, start on 15mg patch.
Example regime: 25mg for 8 weeks, 15mg for 2 weeks, followed by 10mg for 2 weeks.

24 hour patches
A nicotine patch that is worn all day and night which is replaced each morning.

Available in three strengths: 21mg, 14mg and 7mg.
If smoking more than 10 cigarettes per day, start on 21mg.
If smoking less than 10 cigarettes per day, start on 14mg.
Example regime: 21mg for 6 weeks, 14mg for 2 weeks, followed by 7mg for 2 weeks.

How to use nicotine patches

Inhalator

A portable handheld device that releases nicotine when air is sucked through it. The inhalator should be used whenever the urge to smoke is felt or to prevent cravings in situations where these are likely to occur.

Available in 15mg cartridges containing one inhalator mouthpiece.
Use up to 6 cartridges per day. Each cartridge lasts for approximately eight 5 minute sessions. Change the cartridge when there is no longer a taste.

How to use nicotine inhalators

Nicotine gum

A flavoured gum which releases short bursts of nicotine as it is chewed. The gum is chewed until the flavour is released then ‘parked’ between the gum and the cheek until the flavour recedes. This process is repeated on both sides of your mouth.

Available in 2mg, 4mg (and also 6mg).
If smoking more than 20 cigarettes per day use 4mg.
If smoking less than 20 cigarettes per day use 2mg.
Use up to 15 pieces per day for the first 4 to 6 weeks and then gradually cut down to zero.

How to use nicotine gum

Nasal spray

A measured dose of nicotine solution that is sprayed into each nostril up to 1-2 times per hour or as required providing quick relief from cravings. Suitable only for heavy smokers (20 plus cigarettes per day), it is the strongest form of NRT available.

Available in 0.5mg.
Minimum of half an hour in between doses, daily maximum 64 sprays

How to use nicotine nasal spray

Mouth spray

A flavoured nicotine solution that is sprayed into the inside of the cheek, 1 – 2 times every 30 minutes to 1 hour for the first 4-6 weeks, before gradually cutting down to zero.

Available in single 13.2ml and duo pack (2 x 13.2ml).
Each spray contains 1mg of nicotine.

How to use nicotine mouth sprays

Lozenges

Flavoured tablets that slowly dissolve in your mouth, providing short bursts of nicotine to relieve cravings and withdrawal symptoms. Two types of lozenges are available which come in different flavours.

Mini-lozenge
A small tablet that you move around your mouth until dissolved (do not chew or swallow).

Available in 1.5mg or 4mg.
If smoking more than 10 cigarettes per day use 4mg.
If smoking less than 10 cigarettes per day use 1.5mg.
Use between 8 – 15 lozenges per day (don’t exceed 15 in a day)

Microtab (sublingual tablet)
A small tablet that is placed under the tongue and allowed to dissolve (do not chew or swallow).

Available in 2mg.
Use 1 – 2 hourly, up to 40 per day.

How to use nicotine lozenges

Which NRT product should I use?

Research has shown that all these methods can be effective, but the best treatment for you will depend on your personal preference, age and medical history.

Combination or dual therapy – where two or more products are used together – is a popular strategy and can often increase your chances of success.

To help you decide which method, or combination of methods, is right for you, here’s a comparison of some of the pros and cons of each type.

TypeProsCons
PatchesDiscrete and easy to use.

Provides a continuous dose of nicotine.

Can’t take too much or too little.

Don’t need to remember to keep taking it throughout the day.
Not as discrete as gum or lozenges.

Gives you less control over your nicotine intake.

Can cause local irritation to the skin.

It doesn’t provide a physical distraction.

24-hour patches can disturb sleep.
InhalatorsMimics the ‘hand to mouth’ action of smoking to help break the physical habits of smoking.

Held like a cigarette, so it keeps hands busy.

Fast acting.

Have control over when to take it.
Need to remember to keep using it.

Need to decide when to take it.

May cause a sore throat or mouth.

Not as discreet as other methods.
GumVery discrete.

Provides a distraction.

Have control over when to take it.

Easy to use.

Available in different flavours.
Need to remember to keep using it.

Some people don’t like chewing gum.

Difficult to use with dentures.

Some people don’t like the taste.

Some people find it hard getting used to 'parking' gum in their mouths.
Mouth SprayHave control over when to take it.

Easy to use.
Need to remember to keep using it.

May cause hiccups or some local irritation.
Nasal SprayHave control over when to take it.

Nicotine is quickly absorbed.

Ideal for heavy smokers.

Each dose gives an amount of nicotine equivalent to one cigarette.

The fastest acting NRT product.

Mimics the rush from smoking more closely than other NRT products.
Need to remember to keep using it.

Only suitable for heavy smokers.

Possible side effects include sneezing, throat & nose irritation, watering eyes.

Potentially unsuitable for people who suffer with sinus problems or headaches.

Potentially unsuitable for asthma suffers as it can cause temporary shortness of breath.

Can’t be used whilst driving.
LozengesVery discrete.

Provides a distraction.

Have control over when to take it.

Available in different flavours.

A good alternative to gum for people with dentures.

More discreet than gum.

Relieves sudden cravings quickly.
Need to remember to keep using it.

Not everyone likes the taste.

May cause irritation to the tongue and throat.

Can cause indigestion.

Use with caution if you have ulcers.

Always read the instructions before using any NRT product. Speak to your GP or an NHS stop smoking adviser for advice if you are unsure about anything.

Where can you get NRT from?

NRT is available on prescription from a doctor or NHS stop smoking service, or over the counter from your local pharmacy. You may be eligible for free NRT if you qualify for Yorkshire Smokefree Sheffield’s priority quit programme.

Here are the products that are available to buy without a prescription.

TypeProducts available without prescription
12 hour patchesNicorette products:

Nicorette Invisi 10mg Patch
Nicorette Invisi 15mg Patch
Nicorette Invisi 25mg Patch
24 hour patchesNicotinell products:

Nicotinell TTS 10 (7mg)
Nicotinell TTS 20 (14mg)
Nicotinell TTS 30 (21mg)

NiQuitin products:

NiQuitin 7mg Transdermal Patch
NiQuitin 14mg Transdermal Patch
NiQuitin 21mg Transdermal Patch
NiQuitin Clear 7mg
NiQuitin Clear 14mg
NiQuitin Pre-Quit Clear 21mg
InhalatorsNicorette product:

Nicorette Inhalator 15mg
GumNicorette products:

Nicorette 2mg gum
Nicorette 4mg gum
Nicorette Fruit Fusion 2mg Gum
Nicorette Fruit Fusion 4mg Gum
Nicorette Fruit Fusion 6mg Gum
Nicorette Freshmint 2mg Gum
Nicorette Freshmint 4mg Gum
Nicorette Icy White 2mg Gum
Nicorette Icy White 4mg Gum

Nicotinell products:

Nicotinell Mint 2mg Medicated Gum
Nicotinell Mint 4mg Medicated Gum
Nicotinell Fruit 2mg Medicated Gum
Nicotinell Fruit 4mg Medicated Gum

NiQuitin products:

NiQuitin 2mg Extra Fresh Mint Gum
NiQuitin 4mg Extra Fresh Mint Gum
Nasal spraysNicorette product:

Nicorette Nasal Spray
Mouth spraysNicorette products:

QuickMist Mouth Spray 1mg
QuickMist Cool Berry Mouth Spray 1mg
LozengesNicorette products:

Nicorette Cools 2mg Lozenge
Nicorette Cools 4mg Lozenge
Nicorette Fruit 2mg Lozenge
Nicorette 2mg Microtab

Nicotinell products:

Nicotinell Mint 1mg Lozenge
Nicotinell Mint 2mg Lozenge

NiQuitin products:

NiQuitin Mint 2mg Lozenge
NiQuitin Mint 4mg Lozenge
NiQuitin Minis Mint 1.5mg
NiQuitin Minis Mint 4mg

Triple your chances of quitting smoking successfully

NRT is most effective if used alongside support from an NHS stop smoking service. In fact, you are three times more likely to quit successfully if you use this method.

Your local NHS stop smoking service, Yorkshire Smokefree Sheffield, offers free, friendly and flexible support to help you quit smoking. The service has helped thousands of people to go smokefree in Sheffield through telephone support, face to face sessions*, and our unique online quit program.

Talk to an advisor today:
Call 0800 612 0011 (free from landlines
0330 6601 1166 (free from mobiles)
Or request a callback online.

*In light of the covid-19 outbreak all face to face services are temporarily suspended at this time. However you can still get a full range of support over the phone and online.