Nicotine replacement therapy

Cigarettes and other tobacco products contain a chemical called nicotine.

Nicotine is not dangerous to your health. It's the toxic chemicals in tobacco smoke that cause most of the damage to you and those around you.

However, it's nicotine and not tobacco that's addictive. That's why when you want to stop smoking it's very helpful to replace the nicotine and reduce cravings by using nicotine replacement therapy (NRT).

NRTs are things like patches, gums and inhalators that you might have heard of or used to stop smoking before. You can use nicotine vapes to stop smoking if you're aged 18 or over. There are also some prescription-only medications available.

How to use NRTs

Sometimes people can struggle to quit smoking because they aren't using their NRT correctly.

Here are some helpful tips for using NRTs:

  1. You need to find the right strength of product, some are stronger than others. If you're a heavier smoker you will need a stronger product. Your stop smoking advisor, doctor, pharmacist, or reputable vape supplier can help with this. If you want to have a go at figuring it out by yourself you can use this quick Fagerström test.
  2. You can use two types of NRT at the same time. One of these should be what we call 'long acting' which means it gives you a steady supply of nicotine all day without you having to think about it. For example, a patch is good for this. Then you should also have a fast-acting product like an inhalator to use when you get cravings.
Types of NRT

There are many different ways nicotine can be absorbed into the body. Each product has its advantages and disadvantages and it's important to choose the right product for you.

You should always follow the instructions on the packaging when using any of these products.

Nicotine patches

These work by being stuck to the skin, slowly releasing nicotine, which is absorbed into the blood.

They're discreet, easy to use and help with easing cravings due to the relatively long-lasting effect.

Top tip: Put the patch on dry, clean, hairless skin. When you take the old one off and put a new one on, choose a different location. If the patch does not stick you can use plaster tape over the top to keep it in place.

Nicotine gum

You chew the gum is until a tingling sensation begins in the mouth and then tuck it into the inside of your cheek. The nicotine is absorbed through the gums and cheek.

You can chew the gum again until the flavour begins to fade. This can be done for up to 30 minutes.

Top tip: Do not continuously chew the gum. Chew until some flavour is released, then park it between the check and the gums. Chew, park repeat. If you chew continuously you will swallow most of the nicotine which should be absorbed through the cheeks.

Nicotine lozenges

These work by dissolving in the mouth, releasing nicotine which is absorbed by the tongue, cheeks and gums.

The lozenges are discreet and can be used alongside other products, but some may find the taste unpleasant and that they experience irritation.

Top tip: Do not suck, chew or swallow. Put the lozenge between your gums and cheek. You can move it around from one side to the other occasionally.

Nicotine nasal spray

This is sprayed into the nostril and is then absorbed through the lining of the nose.

Nasal sprays mimic the rush you get from smoking more closely than other forms of NRT.

They're easy to use but some people may find they get irritation and a runny nose.

Top tip: You do not need to sniff, swallow or inhale while spraying.

Nicotine mouth spray

Similar to a nasal spray, this NRT is sprayed into the mouth and works very quickly.

It also mimics the rush of smoking. Some people may find it irritates their mouth or throat.

Top tip: Do not spray to the back of your throat. Spray into your cheek.

Nicotine inhaler

This delivers nicotine to your mouth and mimics the hand to mouth motion associated with smoking.

These are not the same as an e-cigarette, as inhalers only deliver nicotine.

Top tip: Do not inhale into the lungs like a cigarette. Take frequent, short, shallow puff, similar to how you might sip from a straw. You may use this more often than if you were smoking.

E-cigarettes

Electronic cigarettes (e-cigs, vapes) are electronic devices that vaporise a liquid containing nicotine and flavourings.

They're thought to carry only a tiny amount of the health risks compared to smoking cigarettes and are an effective tool for quitting smoking.

Top tip: It can take some practice to get used to using these. When you start, take short inhalations, as big inhalations can result in taking too much vapour and experiencing discomfort.

Prescription-only medicines

There are some prescription-only stop smoking medicines, which are in tablet form:

  • varenicline (brand name Champix), there are supply issues and it's not currently available in Bristol
  • bupropion (brand name Zyban)
  • cytisine, this is a new medication that's not currently available everywhere in the UK

These medicines do not contain nicotine, but they can help with withdrawal symptoms.

If prescribed by a doctor, they can be taken together with nicotine replacement products. They are not suitable for everyone.

Vaping

Nicotine vaping is now the most popular and effective way for smokers to quit.

Vaping is the act of breathing in nicotine as an aerosol, or vapour, using a battery-powered electronic device known as a vape or e-cig.

The device heats a solution (e-liquid) which contains nicotine (the addictive part of tobacco) instead of burning tobacco. Nicotine itself has been used safely for many years to help people stop smoking.

Vaping is now one of the most effective tools for quitting smoking.

While vaping is not completely harmless, the health risks associated with vaping are a lot lower than those associated with smoking. This is because, when the e-liquid is heated, you're exposed to fewer toxins than those that are produced when smoking.

You can use different strengths of e-liquid to control cravings and other withdrawal symptoms that can happen when we try to quit smoking. It can also be very useful to help to slowly let go of the habits and routines that you might have developed while you were smoking.

Almost two-thirds of people who use a vape along with support from their local Stop Smoking Service successfully quit smoking.

NHS

Vaping is not recommended for people under the age of 18 or for people who do not smoke. It is illegal for someone aged under 18 to buy a vape.

While vaping to quit smoking is a really positive move for your health, no one knows the long term effects of vaping. This is why we recommend that you aim to stop smoking using your vape, and then aim to reduce then reduce how often you vape until you quit vaping as well.

If you want to buy a vape, we strongly recommend that you go to a specialist vape shop so that you can be confident that the vape you buy is legal and safe for use.

Find out more about some of the common misconceptions about vaping (NHS).