Nicotine Replacement Therapy: Patches, Gums, and Lozenges

Nicotine replacement therapy: Patches, Gums, and Lozenges

Nicotine replacement therapies are designed to provide individuals suffering from nicotine addiction a safer alternative to smoking tobacco cigarettes.

Nicotine replacement therapy is comprised of products which administer to the user small, metered doses of nicotine. These products further omit the approximate 7,000 chemicals found in cigarette smoke. The objective of using nicotine replacement products is to reduce the cravings for nicotine, and ultimately decrease or remove altogether, the symptoms associated with nicotine withdrawal.

Increase Your Chances for Success

According to MedlinePlus, individuals who choose to use one of the many forms of nicotine replacement have an increased chance of success, in fact, ten times higher if relapse does not occur within the first 24 hours of use. However, a higher starting dose may be required depending on how many cigarettes one normally smokes in a day. Participating in some form of counseling program further increases an individual’s chances of long-term success and healthier living as a result.

Not smoking while using a nicotine replacement method is strongly recommended. Smoking while actively using a nicotine replacement product could lead to an extremely dangerous accumulation of nicotine in one’s system, bringing it to harmful, and possibly deadly levels. It is reported that the use of nicotine replacement therapies assists in the prevention of weight gain associated with quitting smoking. It is suggested that nicotine doses be slowly tapered off through time, allowing for a seamless transition to zero nicotine intake.

Over the Counter NRTs

Nicotine Skin Patches

Nicotine patches are placed on the skin, usually the upper arm. They administer a small, regular nicotine application onto the skin, allowing for direct absorption. However, they may also produce strange dreams, minor skin irritation, redness and burning.

Nicotine Gum

Nicotine gum is a form of medicinal chewing gum. The nicotine content is released by chewing the gum until the user senses a slight tingling sensation, at which point the user places the gum between their gums and cheek. Doing this will allow a steady stream of nicotine which is then ingested orally. The downside is most often the taste. They may also be difficult to use in certain formal situations.

Nicotine Lozenges

Much like nicotine gum, lozenges are ingested orally. However, instead of chewing them, they are more akin to hard candy. The user simply allows the lozenge to slowly dissolve, thus, receiving a steady stream of nicotine. However, they may be difficult to use in certain situations where it is inappropriate to partake in the consumption of a food item.

Nicotine Nasal Sprays and Inhalers

Nasal sprays are basic nasal pump-style bottles containing nicotine. They are used in the same manner as cold or allergy relief medicines. They are placed in the nasal cavity, pumped, and nicotine is then inhaled.

Unlike electronic cigarettes that use vape juices and e-liquids to deliver nicotine, (you can find our list of the best e-cigs here), nicotine inhalers are available only by prescription. Nicotine inhalers work like asthma relief inhalers. The mouthpiece is placed in the mouth, pumped, and nicotine is inhaled in metered doses. Although, these forms of prescription NRTs may become habit forming, and further allow for easy misuse, or overuse.

Other Methods

Working out

That’s right – exercise can be a great way to work out the jitters and anxiety experienced by many quitters. And there’s no need to rush out to the gym; even going for a brisk walk or a jog can help. Love swimming? Consider grabbing a local pool membership for a month to give you something to focus on when you quit. Enjoy biking? Grab that bike and go for a long ride when cravings become overwhelming.


Are you stressing out excessively because of the quitting process? Maybe it’s time to pare back. When you are quitting smoking, you must schedule in time to relax and enjoy yourself. Take up a hobby or pursue learning more about something you love.

Drinking Plenty of Liquids

Don’t just drink coffee or alcohol – both of these are poor at rehydration and can actually dehydrate you further. Drinking plenty of water, low-sugar juice, or herbal tea can help to flush toxic chemicals out of your system more quickly. That includes the toxins from cigarettes!

Vitamin C

Make sure you’re ingesting enough Vitamin C. There are many ways to ensure this; drink plenty of orange juice, take vitamin C supplements, or be sure to eat foods that contain plenty of Vitamin C. When adults quit smoking, they require upwards of 500 mg of vitamin C per day.

Cognitive Behavioral Therapy To Help You Quit Smoking Easily

Cognitive behavioral therapy is a form of psychotherapy originally designed to treat depression. Its goal is to identify and eventually change maladaptive thinking patterns, behaviors and emotions that trigger or worsen a number of psychological problems such as depression, phobias, substance abuse and anxiety. As such, it can easily be applied to smoking cessation.

Cognitive Behavioral Therapy to Quit Smoking

By itself, CBT has not been proven to be hugely effective in helping people to quit smoking. Just as vaporizers remain unproven as effective nicotine addiction treatment. However, when combined with nicotine replacement therapy or prescription medication, it can greatly improve the odds of success.

CBT-related Techniques for Quitting Smoking

  • Developing individual strategies to avoid smoking in situations that used to trigger cravings.
  • Changing your thinking patterns related to smoking. For instance, if a patient has a habit of thinking “I need a cigarette” in a stressful situation, a therapist can help replace that thought with “I need some fresh air”.
  • Identifying triggers and learning how to avoid them.
  • Education about nicotine dependence, withdrawal symptoms and quitting strategies.
  • Planning replacement activities to occupy your hands and mouth, like snacking or chewing gum.
  • Relaxation training using breathing exercises.
  • Aversion therapy. Cigarette aversion can be achieved by focusing on the negative aspects of cigarette smoking.

CBT is known to be effective in improving the odds of success. The experience, feedback and motivation provided by a skilled therapist can truly help you to quit smoking. Certain techniques provided by CBT can also be helpful in combating weight gain during the quitting process.

Quitting With Alternative Medicine

The number of alternative therapies aimed at helping people quit is extensive. Anything aside from conventional nicotine patches or gum, the “cold turkey,” approach and prescription medications may be considered an alternative. The most common include hypnosis, meditation, and some supplements. Success rates among these methods vary, with some proving to be quite effective for some smokers.

Nicotine replacement therapy: alternative methods


Studies have shown that hypnosis may be a very promising smoking cessation aid for some people. This method focuses on asking the smoker to make negative mental connections with cigarettes, associating them with such things such as fumes or dry mouth. The most popular of these is Spiegel’s method.

This is the method which has the smoker focus on three main points:

    • smoking is a poison for your body;
    • you need your body to live;
    • to the extent that you want to live, you owe your body respect and protection.


Meditation is a form of deep breathing and relaxation which often has participants envisioning certain thoughts or pictures, repeating specific mantras, or just focusing on their breathing pattern.

There are many methods of performing meditation, and those who choose to try this aspect of treatment may want to explore several variations to determine which works best for them.


There has been some buzz about over-the-counter supplements for use as smoking cessation aids. One such example is St. John’s wort, which has antidepressant properties. The theory was that the supplement may act in much the same way as prescription antidepressants as a smoking cessation therapy, but studies conducted by the Mayo Clinic have not backed up this claim.

Ginseng, however, has shown to suppress nicotine receptors in the brain, which can actually help some smokers quit.

There are many natural supplement widely available to the public. However, one should take caution before reaching for them as an assistant to quitting and make sure to consult a doctor beforehand.

NRT: Taking the First Step

Taking the first step toward quitting smoking is often the most difficult. However, unlike quitting cold turkey, using nicotine replacement therapy provides an edge. They assist by curbing nicotine withdrawal symptoms, decreasing the likelihood of weight gain, and increase the overall chances for long-term success. A doctor may also be consulted when choosing an NRT. They may suggest using other forms of medication, such as Bupropion (Zyban), or Varenicline (Chantix). These medications have also proven to be successful among some users, however, they also carry an increased likelihood of side effects.

Talk with your doctor if you are pregnant or nursing, or plan on becoming pregnant soon; if you currently have any serious medical conditions; if you are currently under the age of 18; or if you are currently using any prescribed medications in order to prevent any possible dangerous drug interactions.

Published: April 13, 2018 Updated: April 5, 2019

Nicotine Replacement Therapy: Patches, Gums, and Lozenges
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