Improve your chances of quitting successfully with stop smoking medicines
Some people find nicotine cravings the hardest thing to handle about quitting. If this sounds like you, then there’s no need to worry. There are plenty of stop smoking medicines out there and they can give you the extra support you need to beat the addiction. Here’s our guide to stop smoking medicines, how they work and how to use them to help you quit for good.
You can access NRT products from Pharmacies, to find out which please click here.
What are stop smoking medicines?
Cigarettes contain nicotine. By smoking regularly and over a long period of time, your body becomes dependent on it. 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 three types of stop smoking medicines:
- Champix tablets (varenicline)
- Zyban tablets (bupropion)
- Nicotine replacement therapies (NRT), including patches, gum, lozenges, microtabs, inhalators and nasal sprays
All are available from the NHS with a prescription, and NRT can also be bought from pharmacies and other shops (such as supermarkets) without a prescription.
How does NRT work?
Where to get NRT products?
Which NRT is right for me?
All licensed nicotine-containing products are effective treatments to help you stop smoking, but you may wish to seek advice from your pharmacy team, doctor or local NHS Stop Smoking Service to help you decide which is right for you. No single NRT product is better than any other and there are a number of options. Discuss the most appropriate product for you with your healthcare professional. Because NRT gives you a lower dose of nicotine than you get from cigarettes, many people use the patch to give a background dose of nicotine and one of the other products to top this up.
Also remember that a full course of NRT can last for 8-12 weeks (depending on the type you are using) so it is important you stick with it! However, if one type of NRT doesn’t work for you, or if you experience any problems or have any questions, talk to your healthcare professional for advice. For all these products, please read the leaflet which will advise you on how to use the medicine and the maximum amount you can take every day.
Is NRT safe? Am I just replacing one addiction with another?
Some people think that using NRT is just swapping one addiction for another. But this isn’t true.
Smoking is highly addictive, largely because it delivers nicotine very quickly to the brain and this makes stopping smoking difficult. The nicotine levels in licensed nicotine-containing products are much lower than in tobacco, and the way they deliver nicotine makes them less addictive than smoking.
Most health problems are caused by other components in tobacco smoke, not by the nicotine. It is safer to use licensed nicotine-containing products than to smoke. There is reason to believe that lifetime use of licensed nicotine-containing products will be considerably less harmful than smoking.
Are there any health implications?
It is safer to use licensed nicotine-containing products than to smoke. NRT products have been demonstrated in trials to be safe to use for at least five years.
NRT is suitable for most adults, 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 doctor or midwife before using NRT.
When should I stop using NRT?
- Champix (Varenicline)
- Zyban (Bupropion Hydrochloride)
- Nicotine gum
- Nicotine patches
- Nicotine nasal spray
Champix (Varenicline) *^
*Only available to people aged 18 or over.
^ Prescription only medication
Champix works by reducing your craving for a cigarette. It also reduces the effects you feel if you do have a cigarette. You set a date to stop smoking, and start taking tablets one or two weeks before this date. Treatment normally lasts for 12 weeks. Champix 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 or healthcare professional.
Zyban (Bupropion Hydrochloride) *^
*Only available to people aged 18 or over.
^ Prescription only medication
Zyban is a tablet which helps you to stop smoking. You start taking Zyban one to two weeks before you quit and treatment usually lasts for a couple of months to help you through the withdrawal cravings. It’s only available on prescription and is not available if you are pregnant, or if you have some pre-existing conditions – discuss this treatment with your doctor or healthcare professional.
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.
When you use nicotine gum, the nicotine is absorbed through the lining of your mouth. When you first quit you should be chewing about one 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 once the taste from chewing has faded.
Gradually you can begin to cut down on the amount of gum you use. Try chewing for shorter periods, using smaller pieces, using the lower-dose gum or alternating with a non-nicotine gum.
Is gum right for me?
Gum can be helpful because it provides short bursts of nicotine. However, some people dislike the taste and habitual users of ordinary chewing gum may find it difficult to get used to having to ‘park’ the gum in their mouth.
Nicotine patches work well for most regular smokers and can be worn round the clock (24-hour patches) or just during the time you are awake (16-hour patches). They work by releasing nicotine directly into the bloodstream through the skin.
How to use patches
There are two ways to use patches: just during the time you are awake (16-hour patches) or both day and night (24-hour patches). The 24-hour patch may cause some sleep disturbance but is helpful for people who 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 use of patches completely.
Are patches right for me?
Patches are useful for those who are concerned about discretion (they can be worn easily beneath clothing) or dislike the taste of the oral products. They release a steady amount of nicotine. They may cause skin irritation for some people.
Lozenges are placed in the mouth and dissolve slowly to release nicotine. They take about 20-30 minutes to dissolve.
How to use lozenges
Nicotine lozenges work in a similar way to nicotine gum. To release the nicotine from the lozenge, suck until the taste becomes strong or hot. After this you can rest the lozenge inside your cheek – once the taste fades you will need to suck again to release more nicotine. Suck until the lozenge has completely dissolved – each one should last 20 to 30 minutes.
You should use lozenges for about 12 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.
Why use lozenges?
Lozenges are helpful because they provide short bursts of nicotine. Lozenges should not be used by people with mouth ulcers.
An inhalator looks like a plastic cigarette. The inhalator releases nicotine vapour which gets absorbed through your mouth and throat. If you miss the ‘hand to mouth’ aspect of smoking, these may suit you.
How to use inhalators
A nicotine inhalator works by releasing nicotine vapour when you suck on it. Inhalators work very quickly so you should use yours whenever you feel strong cravings for a cigarette. Each inhalator contains a disposable cartridge which has enough nicotine for three to four 20-minute puffing sessions. This equates to around 400 puffs.
You should aim to use the inhalator for a total of 12 weeks, though there is no set rule to follow. Use from 6 to 12 cartridges a day for the first eight weeks depending on how many cigarettes you smoke. For the following two weeks reduce this by half and reducing the use of the inhalator gradually in the last two weeks, finally stopping completely in the last two weeks.
Why use an inhalator?
One advantage of inhalators is that they work much more quickly than gum or lozenges. They can therefore be used directly when you experience cravings for a cigarette. They also feel very similar (because of the motion involved in using them) to a cigarette, so become a good replacement – especially for those who miss the ‘hand to mouth’ aspect of smoking.
Nicotine nasal spray
The spray delivers a swift and effective dose of nicotine through the lining of your nose.
How to use nasal spray
You use the nasal spray by releasing one spray into each nostril twice an hour. It should be used no more than five times an hour and no more than 40 doses a day. Each dose gives an amount of nicotine equivalent to one cigarette. This is the fastest way that nicotine can enter the bloodstream, reaching the brain within 10 minutes.
You should use the nasal spray for a total of 12 weeks. Use between one and two doses per hour 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 nasal spray completely in the last two weeks.
Why use the nasal spray?
The advantage of nasal sprays is that they work much more quickly than gum or lozenges. They can therefore be used directly when you experience cravings for a cigarette – and mimic the rush you get from smoking more closely than any of the other form of NRT.
The nicotine nasal spray is the strongest form of nicotine replacement therapy. This can be a very useful and effective form of medication for highly dependent heavy smokers who have difficulty giving up using other methods.
However, this method is not suitable for everyone and may cause side effects such as nose and throat irritation, coughing, and watering eyes.
These are small tablets containing nicotine that dissolve quickly under your tongue.
How to use microtabs
Microtabs are designed to be dissolved under the tongue. Make sure you don’t chew or swallow them – this may cause unwanted side effects.
When you quit you should use one or two tablets every hour for up to three months after you quit. You should then be able to gradually cut back your consumption. Once you are taking one or two tablets a day you should be able to stop completely.
Why use microtabs?
Microtabs can be used by those who are trying to reduce the number of cigarettes they smoke, as well as those who have quit completely. Some people find that microtabs are more discrete than other oral products, as no chewing or sucking is required. You should stop smoking within six months of starting on microtabs.