Some people find nicotine cravings the hardest thing to handle about quitting.

If that sounds like you, then no need to worry. There are plenty of Nicotine Replacement Therapy (NRT) products out there and they can give you the extra support you need to beat the cravings. In fact, like all licensed stop smoking medicines, used in combination with your local Stop Smoking Service you’re four times more likely to stay quit!

How they work

Cigarettes contain nicotine. By smoking regularly and over a long period of time, your body becomes dependent on nicotine. Giving up smoking can cause nicotine withdrawal symptoms, which include cravings, headaches, feeling irritable and not being able to sleep. Stop smoking medicines can help you manage these withdrawal symptoms.

There are two types of stop smoking medicines available when you receive support from Smokefreelife Somerset:

• Nicotine Replacement Therapy (NRT) including patches, gum, lozenges, inhalator and mouthspray
• Varenicline (Champix)

All of them are available from the service, and Nicotine Replacement Therapy can also be bought from pharmacies without a prescription and other shops (such as supermarkets).

All are effective treatments to help you stop smoking, but you may find one suits you more than another. There are lots of things to take into account, so we recommend that you speak to your local Stop Smoking Practitioner, your doctor or pharmacist for further advice.

 

Nicotine Replacement Therapy (NRT)

Is taking nicotine replacement therapy safe?

NRT is suitable for most adults and anyone aged 12 and over, but if you have a heart or circulatory condition, or are on regular medication, you should check with your doctor. Similarly, if you are pregnant you should ask your M2B Practitioner, doctor or midwife before using NRT.

Nicotine Patches

Nicotine patches are an effective treatment for most regular smokers.  They work by releasing nicotine directly into the bloodstream through the skin.

There are two ways to use patches: just during the time you are awake (16 hour patch) or throughout the day and night (24 hour patch). The 24 hour patch may cause some sleep disturbance but is helpful for people who routinely smoke through the night or have strong cravings during the early morning.

Patches also come in different strengths. Whichever strength you start on you should aim to gradually reduce the strength over time before stopping the usage of patches completely.

 Nicotine Gum

When you use nicotine gum, the nicotine is absorbed through the lining of your mouth. When you first quit you should be chewing about 1 piece of gum every hour. To release the nicotine from the gum, chew until the taste becomes strong or hot. After this you can rest the gum inside your cheek. Once the taste or heat fades you will need to chew again to release more nicotine. Discard the gum after about 30 minutes.

Gum is available in two strengths: 2mg and 4mg. The 4mg gum is most appropriate for smokers who smoke more than 20 cigarettes a day, or who are strongly addicted to nicotine.

Gradually you can begin to cut down on the amount of gum you use or alternate with a non-nicotine gum.

Nicotine Lozenge

Lozenges dissolve gradually over 10-15 minutes releasing nicotine which is absorbed through the lining of the mouth.

As with all NRT products, you should use lozenges for about twelve weeks. For the first six weeks you should have one lozenge every one to two hours. You should then reduce your intake to one lozenge every two to four hours, finally reducing to once every four to eight hours in the last two weeks of treatment.

 Inhalators

The inhalator contains a small cartridge of nicotine, the vapour from which gets absorbed through your mouth and throat. It is not the same as an e-cigarette or ‘vape’ as there is no battery or heating coil involved.  If you miss the ‘hand to mouth’ aspect of smoking, these may suit you.

The nicotine vapour is released when you suck on the inhalator tube. The nicotine is then absorbed through the lining of the mouth rather than through the lungs, so it’s best just to puff the vapour into your mouth.  It will take quite a few puffs to get the same amount of nicotine as one puff on a cigarette and each cartridge contains enough nicotine for around 4 x 10 minute uses.

You should use the inhalator for a total of twelve weeks. Use between 3-6 cartridges per day for the first eight weeks depending on how many cigarettes you smoke. For the following two weeks reduce this by half, finally stopping the use of the inhalator completely in the last two weeks of treatment.

Nicotine Mouthspray

The spray delivers a swift and effective dose of nicotine through the lining of your mouth.

It is the fasted acting of all the nicotine replacement products currently available, but as with all products it is tolerated better by some than others.

You can have 1 to 2 sprays every 30 minutes or to relieve cravings as they come.

After 8 weeks you should gradually reduce the amount of spray being used, aiming to stop use after 12 weeks

 

Varenicline

Unfortunately we are unable to provide Champix (Varenicline) until further notice as Pfizer, who are the sole supplier of Champix (Varenicline), have temporarily stopped the distribution of all Champix tablets. We understand that supply of varenicline will not recommence in the short term and that it could be many months, or longer, before Pfizer are able to guarantee supply of Champix.

Only available to people aged 18 or over. This is a prescription only medication

Varenicline works by reducing your craving for a cigarette and by reducing the effects you feel if you do have a cigarette. You set a date to stop smoking, and start taking tablets 1 or 2 weeks before this date. Treatment normally lasts for 12 weeks. Varenicline is only available on prescription and is not available if you are pregnant or if you have some pre- existing conditions – discuss with your Doctor, health care professional or stop smoking practitioner.

For more information please read the Patient Information Leaflet.

 

E-Cigarettes

E-cigarettes are not licenced as stop smoking medications

Public Health England reports that e-cigarette use is around 95% less harmful to health than smoking. The report encourages smokers who want to use e-cigarettes as an aid to quit smoking to seek the support of their local stop smoking service. Smokefreelife Somerset has experienced staff who can provide support, and advice through the quitting process, but the service does not supply e-cigarettes.

What is an e-cigarette?

E-cigarettes are devices that deliver nicotine within an inhalable aerosol by heating a solution that typically contains nicotine, propylene glycol and/or glycerol, plus flavours. This aerosol is commonly referred to as vapour and so the use of an e-cigarette is described as vaping. Unlike cigarettes, there is no combustion (burning) involved in e-cigarettes so there is no smoke or chemicals such as tar and carbon monoxide.

E-cigarettes generally consist of a battery, a heating element or coil (atomiser) and e-cigarette liquid (e-liquid). The e-liquid can be in sealed cartridges or added to a tank system. Some e-cigarettes use cartomisers that combine the atomiser and e-liquid in a single unit. Although some cartomisers are refillable, most are disposable and designed for single use

Are e-cigarettes safer for me than smoking?

Experts estimate that e-cigarettes are, based on what we know so far, around 95% safer than cigarettes. Smoking is associated with a number of very serious health risks to both the smoker and to others around them. Therefore smokers who switch from smoking tobacco to e-cigarettes substantially reduce a major risk to their health.

Are there any adverse health effects of e-cigarettes?

Although e-cigarettes are not completely risk free, experts agree that they are substantially less harmful than smoking.  There is good evidence that nicotine is associated with few health risks in smokers. It is the tar and toxicants in tobacco smoke rather than nicotine that causes the adverse health effects of smoking.

Do I use e-cigarettes in the same way that I smoke cigarettes?

Vaping is not the same as smoking and involves a slightly different technique to inhaling on a cigarette. Ask the retailer or an experienced user for advice on correct usage and dosage.

Can I use e-cigarettes if I am pregnant?

E-cigarettes are a great deal safer than smoking but we don’t know yet if there are any risks to the baby from exposure to e-cigarette vapour, therefore licensed stop smoking medications are currently the recommended option. However, if you choose to use an e-cigarette to quit or to reduce the number of cigarettes that you smoke during pregnancy, Smokefreelife Somerset have a pregnancy specialist who can provide advice and support.