The nicotine patch provides a steady release of nicotine.
The nicotine patch is a small, self-adhesive patch that slowly releases nicotine into the bloodstream through the outer layer of skin. It can be applied anywhere between the waist and neck — often on the upper arm or shoulder. Patches must be replaced every 24 hours. To minimize potential skin irritation, avoid putting the patch in the same place more than once every two weeks or so.
Brand names include Nicoderm CQ and Habitrol. Generic patches also are available.
Nicotine gum keeps your mouth busy. It can help satisfy cravings quickly.
- <LI class=doublespace>Pros: The patch is easy to use and provides a steady release of nicotine. It's available without a prescription and in various doses. This flexibility allows you to manage your withdrawal symptoms and cravings, as well as to gradually taper the amount of nicotine you receive as you become more comfortable not smoking. <LI class=doublespace>Cons: You can't quickly adjust the amount of nicotine in the patch in response to cravings. The patch may cause itching and irritation where it's applied. Other side effects may include dizziness and upset stomach. Occasionally, patches may cause sleep disturbances and vivid, colorful dreams. Removing the patch at night may help. <LI class=doublespace>Timelines: The patch should be used for at least eight weeks and often longer if withdrawal symptoms persist.
- Caution: The patch may not be appropriate if you have certain skin conditions, such as eczema or psoriasis. Don't smoke while using the patch. You may get too much nicotine and experience nausea or dizziness.
Nicotine gum is made of a special material called polacrilex. To release nicotine from the gum, chew a piece until it has a peppery taste or you notice a tingly sensation in your mouth. Then, to absorb the nicotine, hold the chewed gum between your gum and cheek until the taste or tingly sensation disappears. Chew and hold again to release more nicotine. Repeat the cycle for about 30 minutes, until most of the nicotine has been released from the gum. Nicotine gum comes in several flavors.
Brand names include Nicorette and Thrive. Generic gum also is available.
Nicotine lozenges can be used discreetly to quickly satisfy cravings.
- <LI class=doublespace>Pros: Nicotine gum can help satisfy cravings quickly. It also keeps your mouth busy. You can buy it over-the-counter in 2- or 4-milligram doses and chew it as often as needed — up to 24 pieces a day. When nicotine gum is used alone, most people find it most effective to chew one piece every hour for the first few weeks. <LI class=doublespace>Cons: Nicotine gum may cause gum, tooth or jaw soreness if chewed like regular gum. You may experience nausea or hiccups if you chew it too fast or swallow the nicotine rather than holding the gum against the side of your mouth as directed. <LI class=doublespace>Timelines: Nicotine gum is recommended for up to 12 weeks.
- Caution: Nicotine gum may stick to dentures or other dental work. Don't smoke while using the gum. You may get too much nicotine and experience nausea or dizziness.
Nicotine lozenges are similar to hard candy. You place them between your gum and cheek and suck them slowly. Each lozenge lasts 20 to 30 minutes.
Lozenges are sold under the brand name Commit.
The nicotine inhaler allows you to mimic the hand-to-mouth motions of smoking.
- <LI class=doublespace>Pros: Nicotine lozenges can be used discreetly to quickly satisfy cravings. You can use them as often as needed, up to 20 lozenges a day. They're available in 2- or 4-milligram doses without a prescription. Lozenges come in several flavors. <LI class=doublespace>Cons: Occasionally, they may cause nausea, heartburn or hiccups. <LI class=doublespace>Timelines: Nicotine lozenges are recommended for up to 12 weeks.
- Caution: Nicotine lozenges may stick to dentures or other dental work. They're not meant to be chewed or swallowed whole. Don't smoke while using the lozenges. You may get too much nicotine and experience nausea or dizziness.
The nicotine inhaler is a device that allows you to receive low doses of nicotine using the same hand-to-mouth motions of smoking. When you puff gently on the device, nicotine vapor is released from a cartridge inside the device. Hold the vapor in your mouth for a few seconds and then blow it out — don't try to inhale it into your lungs. The nicotine is absorbed through the lining in your mouth and throat.
The inhaler is available by prescription under the brand name Nicotrol.
Nicotine nasal spray
Nicotine nasal spray
The nicotine in nasal spray reaches the bloodstream more quickly than do the other nicotine replacement medications.
- <LI class=doublespace>Pros: You control the dose of nicotine you receive. You can take as few puffs as needed to satisfy withdrawal symptoms or cravings and save the rest of the cartridge for later in the day. The inhaler also keeps your hands and mouth busy. <LI class=doublespace>Cons: It may initially cause coughing and mouth or throat irritation. <LI class=doublespace>Timelines: The inhaler is often used for six to 12 weeks. Most people use six to 16 cartridges a day at first and gradually taper to nothing.
- Caution: The inhaler may not be appropriate for people who have lung diseases, such as asthma. Don't smoke while using the inhaler. You may get too much nicotine and experience nausea or dizziness.
Nicotine nasal spray is sprayed inside your nostril. The recommended dose is a spray in each nostril one to five times an hour.
It's available by prescription under the brand name Nicotrol.
Varenicline is a prescription stop-smoking medication that doesn't contain nicotine.
- <LI class=doublespace>Pros: The nicotine in nasal spray reaches the bloodstream more quickly and begins working faster than other nicotine replacement medications. You control the dose. <LI class=doublespace>Cons: Side effects often include nasal, sinus and throat irritation. You may also develop watery eyes, sneezing and coughing. Most of these symptoms go away after a short time of regular use. <LI class=doublespace>Timelines: Nicotine nasal spray is often used for eight to 12 weeks. Most people use one to two mists an hour at first and gradually taper to nothing.
- Caution: Nicotine nasal spray isn't recommended for people who have a nasal or sinus condition, allergies or asthma. Don't smoke while using the nasal spray. You may get too much nicotine and experience nausea or dizziness.
Varenicline can help control cravings for tobacco and nicotine withdrawal symptoms. It also blocks nicotine receptors in your brain, which in turn reduces the response to nicotine that you get from smoking a cigarette. This can make it easier to stop smoking. Varenicline is available by prescription.
Varenicline is sold in the United States under the brand name Chantix. In Europe, varenicline is sold as Champix.
- <LI class=doublespace>Pros: Varenicline is a pill, so it's easy to use. It doesn't contain nicotine and isn't addicting. <LI class=doublespace>Cons: Side effects may include nausea, insomnia and a variety of mood and behavior changes. Rarely, a severe allergic reaction can occur. <LI class=doublespace>Timelines: Varenicline is recommended to be used for six months, beginning one to two weeks before you plan to quit smoking. For the first three days of varenicline therapy, most people take a 0.5-milligram tablet each morning with breakfast. On the fourth day, they begin taking another 0.5-milligram tablet with their evening meal. On the eighth day, 1 milligram at breakfast and 1 milligram at dinner is started. To minimize nausea, it's recommended that varenicline be taken with a full glass of water after a meal.
- Caution: Varenicline should be used with caution in people who have severe kidney problems. In addition, quitting smoking with varenicline may be associated with anxiety, nervousness, tension, depressed mood, unusual behaviors and thinking about or attempting suicide.