Nicotine

Please note: these are basic guidelines, refer to your doctor for a professional medical opinion.

Popular brand names:

Nicorette, Quit

Drug group:

Smoking cessation aid

Prescription needed?

No

What does it do?

Nicotine replacement therapy is used to help people to stop smoking.

How does it work?

Taking nicotine in a different form helps smokers to stop the habit by addressing the nicotine addiction, as well as the psychological aspects of smoking.

Nicotine-containing electronic cigarettes (e-cigarettes) are now available but not currently recommended as their safety and effectiveness for smoking cessation has not been established.

How should it be used?

• All forms of nicotine replacement therapy should NOT be used with other nicotine-containing products including cigarettes and e-cigarettes
• Heavy smokers should start with patches until cravings disappear, and then use intermittent forms when the urge to smoke returns
• Patches should be applied every 24 hours to unbroken/dry/non-hairy skin on the trunk or upper arm, and the same area of application should be avoided for several days

What is the typical dosage?

Dosage will depend on your previous smoking habits, but typically:

• Patches: 7–22mg per day, replace every 24 hours, patch can be removed after 16 hours
• Intermittent forms: tablets/lozenges every hour as needed; gum 2mg once daily to 4mg 15x per day; spray: up to 64 x 0.5mg puffs daily

How quickly will it start to work?

Patches: a few hours; other forms: within minutes  
        

How long will the effects last?

Patches: up to 24 hours; other forms: 30 minutes

When should I stop using it?

The dose is normally reduced gradually until no longer needed.          
 

Is it safe for prolonged use?

Nicotine replacement should not be used for more than 3-6 months.

What are the possible side effects?

The following have been reported:

• More common: local irritation (skin reactions, irritation of the nose/throat, taste disturbances, dry mouth), headache, dizziness, nausea, indigestion, cold/flu-like symptoms, insomnia
• Report to your doctor before taking your next dose if you experience: chest pains, palpitations

What other considerations are important?

Dosage may be adjusted by your doctor under certain conditions.

• Certain health problems: liver/kidney/heart problems, diabetes mellitus, thyroid disease, history of peptic ulcers, phaeochromocytoma
• Other medicines: Stopping smoking may increase blood levels of warfarin, theophylline, aminophylline, and antipsychotics
• Pregnancy and breast-feeding: Nicotine replacement can be used by pregnant smokers unable to quit, but intermittent forms are preferable to patches. Nicotine is found in breast milk but using nicotine replacement to stop smoking is safer than continuing to smoke.
• Children: Nicotine products should not be given to children
• Over 60: No special problems
• Driving and hazardous work: Usually no problems
• Alcohol: No special problems