Nicotine Replacement Therapy

Repeated studies have shown that when smokers use NRT (with appropriate support and advice) to help them quit, they have around double the chance of success, compared to people using willpower alone. (xii)

How it works

NRT replaces some of the nicotine the smoker gets from cigarettes but does not deliver the harmful chemicals or gases.  NRT can supply the ‘nicotine receptors’ in the brain with sufficient therapeutic nicotine to control withdrawal symptoms, while leaving the smoker free to concentrate on breaking their behavioural dependence on cigarettes. It is important that smokers using NRT products should stop smoking completely.

Some NRT products have also been given ‘cut down and stop’ licences which means that the smokers who are not ready to quit abruptly can use NRT to relieve the cravings while cutting down on the number of cigarettes they smoke.

NRT products
There is a range of different NRT products available:

1. Patch - e.g. NiQuitin CQ available in the following strengths 21mg, 14mg and 7mg as clear or pinkish tan patches.
Patches allow nicotine to be absorbed through the skin in a constant manner, avoiding the high, rapid peaks that occur with smoking. NiQuitin CQ is available as a 24 hour patch and can be worn day and night. It is available in three strengths. The customer reduces the strength of patches used over a period of ten weeks until they are no longer need. This step- down programme allows for a gradual weaning off nicotine. If you smoke more than 10 cigarettes a day you should start with the 21mg strength Patch, or start with 14mg strength if you smoke ten or fewer cigarettes per day.
There are also 16-hour patches available in different strengths of 5mg, 10mg and 15mg.
Suitable for: Those with regular smoking patterns and those who have a low level of behavioural dependence on cigarettes.

2. Nicotine chewing gum - e.g. NiQuitin CQ Gum available in the following strengths 2mg and 4mg.
The gum should be chewed slowly until the taste becomes strong, then it should be ‘parked’ between the cheek and gum to allow the nicotine to be absorbed through the lining of the mouth.
NiQuitin CQ 2mg and 4mg  Gum can be used as part of a programme designed to support the customer to stop smoking by gradually reducing the quantity and strength of the gum used and the amount used.
Suitable for: The 4mg gum is suitable for the smoker who needs their first cigarette in less than half an hour or those with an irregular smoking pattern.

3. Lozenges - e.g. NiQuitin CQ 2mg and 4mg lozenges.
These are placed in the  mouth and allowed to dissolve. It should be moved from side to side of the mouth periodically until it is completely dissolved. The lozenge should not be chewed or swallowed whole.
Available in lower doses (for medium-low dependent smokers), and higher doses for heavier smokers.
Suitable for: Those with an irregular smoking pattern who want a discreet and flexible form of NRT. Also helpful for customers who crave for a cigarette in certain situations e.g. socialising with friends and for those who need their first cigarette within the first half an hour of waking who can take the 4mg lozenge.

4. Other NRT Preparations:
-  Inhalator: This is a mouthpiece with a plug impregnated with 10mg nicotine, which, when inhaled, is absorbed through the mouth.
- Sublingual tablets: Like gum and lozenges, these release nicotine, which is absorbed through the mouth.
- Nasal spray: By spraying into the nostrils, nicotine is quickly absorbed by the body.

<PRACTICE POINT>
1. Having read about the different NiQuitin products , now think about which products you would recommend to the following customers to help them quit smoking:
a. The reluctant smoker who is only giving up smoking because his family says so! He indicates that he works long hours in an office environment and needs a cigarette to calm him down.
b. A heavy smoker attempting to give up smoking for the first time. This customer is a long distance lorry driver and is worried about taking any medication.
2. What other advice would you give these customers to help them quit or cut down on smoking?

<PRACTICE POINT>
For each of the following products:
NiQuitin CQ Patches
NiQuitin CQ Gum
NiQuitin CQ Lozenges
a. Pick up the product and look at the directions and dosage on the pack. You could use this customer information to help you when explaining the product to a customer.
b. What are the advantages and disadvantages of each of these products?

For more information and guidance in recommending NRT and supporting customers through the quitting process, visit the e-learning section of the website.