Nicotine replacement therapy
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Nicotine replacement therapy (NRT) is the use of various forms of nicotine delivery methods intended to replace nicotine obtained from smoking or other tobacco usage. These products are intended for use in smoking cessation efforts to help deal with withdrawal symptoms and cravings caused by the loss of nicotine from cigarettes. Several forms of NRT have been marketed, including the nicotine patch, inhaler, nasal spray, gum, sublingual tablet, and lozenge. NRT is thought to be useful and beneficial for tobacco users who want to quit their addiction and is for most people perfectly safe. Cigarettes on the other hand cause the early deaths of about 5 million people each year[1]. These people are not killed by the nicotine in the cigarette, but by other constituents of tobacco smoke such as Carbon Monoxide and tars. It is the nicotine that keeps the smoker addicted. Cigarettes can be viewed as a "dirty" and dangerous method of delivering nicotine, while NRT is a "clean" and safe method.
NRT delivers nicotine to the smoker's brain in a much slower way than cigarettes do. The main problem with this nicotine delivery is that it makes one feel overly constipated. This is the negative side effect. Many people complain about cramps, or other types of pain in the abdominal region. It helps to damp down the urges to smoke that most smokers have in the early days and weeks after quitting, rather than remove them totally. It gives the smoker the chance to break smoking cues in their daily lives, and might provide a more comfortable exit from the smoking habit. NRT however is best used with some form of support, ideally from someone who knows something about smoking cessation.
In 2005 the Committee on the Safety of Medicines recommended that NRT be given to pregnant smokers and also to adolescent smokers.
Findings from a recent Cochrane review of controlled trials testing NRT products (Stead et al. 2008) indicated that smokers using NRT were 1.5 to 2 times more likely to be abstinent from smoking at followup than those in the placebo or control treatment condition.
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Nicotine is the addictive drug in tobacco products, and it is a topic of debate whether or not it is a carcinogenic substance. One current theory suggests that it is the harmful ionizing radiation that tobacco leaves absorb which actually gives smokers cancer, rather than the nicotine content of the cigarettes themselves. While studies have shown that many of the constituents of tobacco smoke are carcinogenic, they fail to produce any evidence that nicotine itself is a carcinogen. Also, there is a chance when using NRT products, to become addicted to those products in place of the tobacco habit. Generally it is argued that NRT products are safer than smoking tobacco. NRT products are generally expensive, sometimes even more than cigarettes, so a minority of people may become addicted to the NRT product and turn back to tobacco products to save money. Typically, the cost of NRT is £20 over the counter, whether spray, gum or inhaler, as against £5 for tax paid cigarettes, or £3 for tax paid rolling tobacco...so the financial cost is very great. However, the British NHS provides enormous help in the form of prescriptions, reducing the cost to £7 per script, and if several products are included on one script then the price will drop well below that of actual cigarettes.
[edit] Types
- Nicotine patch
- Nicotine gum
- Nicotine inhaler
- Nicotine lozenge
- Nicotine spray
- Nicotine sublingual tablet
[edit] References
- Stead LF, Perera R, BullenC,Mant D, Lancaster T.Nicotine replacement therapy for smoking cessation. Cochrane Database of Systematic Reviews 2008, Issue 1. Art. No.: CD000146. DOI: 10.1002/14651858.CD000146.pub3.[2]
- Silagy C, Lancaster T, Stead L, Mant D, Fowler G. Nicotine replacement therapy for smoking cessation. The Cochrane Database of Systematic Reviews 2004, Issue 3. Art. No.: CD000146.pub2. DOI: 10.1002/14651858.CD000146.pub2. abstract|full text
- Real-world efficacy of prescription and over-the-counter nicotine replacement therapy, by Shiffman S, et al., published May 2002 in Addiction, Issue 97(5) at Pages 505-516 Entrez PubMed
