Family doctor

Overview:

• Nicotine replacement is a stop-smoking aid
• Nicotine replacement is available in patches, gum, spray, and an inhaler device
• Studies show nicotine replacement doubles smoking cessation rates
• Smokers should not use tobacco while using nicotine replacement
• The cost of nicotine replacement is a barrier to many people who want to stop smoking
• Health advocates believe nicotine replacement should be available on prescription

What is it?

Nicotine replacement therapy is used to help people stop smoking.

Quitting smoking is difficult and many people only achieve their goal by using nicotine replacement products.

A review of more than 45 studies has shown nicotine replacement doubles smoking cessation rates.

Nicotine replacement contains nicotine to help stop cravings and withdrawal symptoms in smokers who are trying to give up.

The nicotine found in replacement therapies do not contain other cancer-causing ingredients found in tobacco.

The World Health Organisation has identified smoking as the most preventable cause of death in developed countries.

Smoking has been linked to increased rates of many diseases including heart disease and cancer. Ex-smokers remain at greater risk for some diseases many years after they have quit. The risk of heart disease declines fairly rapidly after 2 years or sooner and the risk of lung cancer approaches that of the general non-smoking population after 10 years.

Passive smoking also increases the risk of lung cancer, sudden infant death syndrome, and respiratory illness in children.

There are considerable public health gains from people giving up smoking.

What products are available?

Nicotine replacement is now available in several forms. There are patches, gum, nasal spray, and a nicotine inhaler which looks similar to a cigarette.

Products are available in different doses. Higher doses should be used when a person first stops smoking and then they are advised to take lower doses after the first three to six weeks of treatment.

People can gradually stop using the therapy after 12 weeks and nicotine replacement should not exceed six months.

The effectiveness of the different products are about the same. Smokers should decide which product suits them best.

Warning information:

• People should not smoke or use other nicotine-replacement products while taking another nicotine therapy.
• The effects of nicotine on fetal development and breastfed babies is not known. Nicotine replacement is not recommended for pregnant women as a first-line anti-smoking aid.
• People can become addicted to nicotine replacement therapy.
• Nicotine replacement should not be used for more than six months.
• The risks of nicotine replacement in patients with certain heart conditions and respiratory diseases such as asthma, should be weighed against the benefits of using it in a smoking cessation programme.

Future trends

Health advocates believe the cost of nicotine replacement therapy is a barrier for smokers who want to quit. They say it is a cost effective heath measure, and are lobbying to have nicotine replacement funded by governments to help reduce the health costs of smoking.

Getting help

Smoking cessation clinics are available in some centres which provide counselling for smokers trying to quit.

Your doctor or pharmacist will be able to help with advice on nicotine replacement products.