Facts about nicotine replacement therapy (NRT)

What is nicotine replacement therapy (NRT)?

NRT are medications that replace some of the nicotine you would otherwise get from tobacco smoke and can help people who smoke stop smoking. NRT replaces a harmful way of delivering nicotine with a safer alternative. Forms of NRT include:

    • patches
    • gum
    • lozenges
    • mouth spray
    • inhalator.
    Does NRT work?

    Clinical trials show that NRT can more than double the chance of successfully quitting if combined with support like Quitline counselling – 13 7848. A single form of NRT contains less nicotine than a cigarette so you may still experience some cravings and feelings of nicotine withdrawal.

    How does NRT work?

    Nicotine is the substance in tobacco that causes dependence. It is delivered extremely fast to the brain through tobacco smoke, providing a quick hit of pleasure.

    NRT provides some nicotine, helping people who are stopping smoking deal with cravings and feelings of withdrawal such as irritability, anxiety, depression and restlessness. NRT delivers the nicotine much more slowly than cigarette smoke so the person doesn’t experience the same buzz. But people tend to find their cravings and feelings of withdrawal are not as strong when they are using NRT.

    How long does NRT take to work?

    There are two different types of NRT that release nicotine at different rates:

    1. Longer-acting (patches).
    2. Faster-acting (gum, lozenges, mouth spray, inhalator).

    Patches are applied to the skin and provide a steady release of nicotine over 16 or 24 hours. Once applied, it can take several hours for the nicotine to reach peak effect so it is recommended that you also have a faster-acting form of NRT, such as the lozenge or gum, on hand for when you anticipate a craving coming on.

    The faster-acting forms of NRT can reduce cravings and feelings of withdrawal such as difficulty concentrating, frustration, restlessness and anxiety.

    Can I use two different types of NRT at once?

    Using two types of NRT together (a nicotine patch and a faster-acting type, such as the mouth spray, gum, lozenge or inhalator) is called combination therapy. Most people who smoke have a better chance of success if they use combination therapy. Talk to your doctor or pharmacist to see if combination therapy is suitable for you.

    How long should I use NRT?

    Some people stop using NRT too soon and can go back to smoking.

    It’s important to keep using NRT while you work on ways to manage your triggers to smoke. This can take many weeks. It’s recommended that you use NRT for at least eight weeks.

    Talk to your doctor or pharmacist about the length of time that would be best for you.

    How can I predict a nicotine craving?

    NRT is great to use in anticipation of cravings. To plan for your cravings, think about situations where you might get an urge for a cigarette. NRT can be helpful in these situations so keep it on hand. These scenarios might include:

    • parties and other social events
    • travelling between home and work or other places
    • drinking alcohol
    • having a cup of tea or coffee
    • when you are stressed
    • when you are with a person who smokes.
     Can I get addicted to NRT?

    The amount of nicotine in NRT is less than in a cigarette and it takes longer for the nicotine in NRT to get to the brain. Both of these factors mean it is unlikely you will become addicted to NRT. Some people stay on NRT for a longer period if recommended by their doctor because of their strong dependence on nicotine. But this is still safer than continuing to smoke. Speak to your doctor or pharmacist for advice.

    Does NRT have side effects?

    NRT side effects are usually mild and are often related to the form of NRT. Not using the form correctly can also result in side effects. For example, the nicotine patch can cause skin irritation if it isn’t put on a different bit of skin each day. And some people get the hiccups from the faster-acting forms of NRT if they aren’t using them correctly. Serious side effects are very rare.

    Sometimes feelings of withdrawal can be mistaken for an NRT side effect. To learn about the specific side effects of each form of NRT and to make sure you are using them correctly, read the information that comes with the NRT or talk to your doctor or pharmacist.

    Is NRT safe?

    Each form of NRT has to pass the Therapeutic Goods Administration’s tough safety standards before it can be sold in Australia. It is recommended that you talk to your doctor or pharmacist to find out if NRT is right for you and which form is most suitable.

    Can I smoke while I am using NRT?

    Unless you’ve gone back to smoking your regular amount, don’t stop using NRT. It’s safe to keep using NRT to help you quit. If you are using NRT and have a cigarette (or even a few) while trying to stop smoking, it doesn’t mean you’ve failed. Speak to your doctor or pharmacist to work out the best solution for you. You can also speak to Quitline (13 7848) about ways to manage your triggers to smoke.

    Where do I buy NRT?

    You can buy NRT at the pharmacist over the counter. NRT are available at some supermarkets and petrol stations. You don’t need a prescription, although you will need one if you want to get the Pharmaceutical Benefits Scheme (PBS) discounted price.

    Is NRT cheaper than smoking? 

    In the long run, NRT is cheaper than smoking – and it’s not an ongoing cost. If you successfully stop smoking, you won’t be paying for cigarettes or NRT in future. It helps to shop around for your NRT because the price can differ between brands and retailers.

    A 12-week supply of nicotine patches, gum or lozenges can be purchased more cheaply through the PBS once in a 12-month period. You will need a prescription from your doctor.

    If you identify as an Aboriginal or Torres Strait Islander person, you can access two subsidised courses of NRT in a 12-month period and you may be able to access some forms of NRT for free or for a small co-payment through Closing the Gap (with a prescription from your doctor). To find out more, talk to your doctor or phone the Quitline – 13 7848. 

    Can I use NRT while I am pregnant?

    NRT is an option for stopping smoking during pregnancy, for pregnant women who are having trouble smoking. Using nicotine medications/NRT is safer than smoking, but it’s important to discuss the risks and benefits with your maternity care provider.

    If you are pregnant, the better options are the faster-acting forms such as the nicotine lozenge, gum or inhalator. These forms provide a lower daily dose of nicotine than the nicotine patch.

    If the faster-acting medication alone isn’t controlling cravings and feelings of withdrawal, the nicotine patch can also be used. Your maternity care provider may tell you to remove it before going to bed.

    Can I use NRT while breastfeeding?

    If you are breastfeeding, you can use the faster-acting forms such as the nicotine lozenge, gum or inhalator. It’s important to discuss the risks and benefits with your doctor or pharmacist. If you do use faster-acting NRT, try to breastfeed your baby first, then use your faster-acting NRT soon after.

    If the faster-acting NRT alone isn’t controlling cravings and feelings of withdrawal, the nicotine patch can also be used. Your doctor or pharmacist may tell you to remove it before going to bed.

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