Nicotine replacement therapy

Nicotine replacement therapy (NRT) works by substituting the source of nicotine to “replace” the nicotine you inhale when you smoke. For people who are quitting smoking, NRTs can help by delivering a safer alternative source of nicotine than cigarettes. They also can reduce or eliminate the symptoms of withdrawal, making it easier for some people to quit. NRTs have been extensively tested and used by millions of people. They are considered safe and effective ways of quitting smoking.

Nicotine replacement therapy options

Possible effects of too much nicotine

  • feeling sick, faint or light headed
  • headache
  • palpitations

Possible side effects from stopping smoking

  • irritability                                 
  • low mood                              
  • anxiety                              
  • restless         
  • poor concentration               
  • urges to smoke                    
  • lower heart rate               
  • increased appetite
  • weight gain                            
  • sleep disturbance

Precautions when using nicotine replacement

Cardiovascular disease

Using nicotine replacement is less hazardous than smoking. If you have had a heart attack, severe dysrhythmia or a stroke within the last four weeks you should ideally try to stop smoking independently. If you are unable to stop smoking, using nicotine replacement is less hazardous than smoking and should be used under supervision.

Diabetes mellitus

As nicotine can affect your carbohydrate metabolism you may require less insulin as a result of stopping smoking or reducing the amount of nicotine replacement. It is therefore recommended that you monitor your blood sugar levels closely.

Phaochromocytoma/uncontrolled hyperthyroidism

Use nicotine replacement with caution with these conditions. This is because when you stop smoking your metabolism is slower and consequently there may be a rise in the blood levels of the following drugs: theophylline, clozapine and ropinirole

Peptic ulcer/inflamed stomach lining

Some oral nicotine replacement products can cause irritation to the stomach. If irritation occurs then consider switching to non-oral products.

How does this medicine affect other medicines?

Nicotine replacement does not affect other medicines. However smoking can cause medicines to be removed from the body faster. Therefore when you stop smoking you process your medication slower and may need a lower dose. Talk to your doctor if you take the following:

  • aminophylline
  • dextropropoxyphene
  • olanzapine
  • chlorpromazine
  • flecainide
  • pentazocine
  • cinacalcet
  • fluphenazine
  • ropinirole
  • clozapine                  
  • theophylline