Smoking Treatment

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• QDoes nicotine replacement therapy help people stop smoking?

  5 Answers

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  A Dr. Darria Long Gillespie, MD , Emergency Medicine, answered

  The US Public Health Service Guidelines recommend nicotine replacement therapy for almost all smokers who are trying to quit. NRT increases the chances of successfully quitting by 50% to 70%. This effectiveness does not depend on length of treatment, how the therapy is offered, or any additional support or supervision provided.
  
  Studies show that combination NRT is one of the most effective aids to quitting smoking. The nicotine patch used along with nicotine gum, nicotine nasal spray, or bupropion is highly effective. 
  
  This answer was adapted from Sharecare's award-winning AskMD app. Start a consultation now to find out what's causing your symptoms, learn how to manage a condition, or find a doctor. 

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• QWhat are side effects of using a nicotine gum or lozenge to quit smoking?

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  A Dr. Frank T. Leone, MD , Pulmonary Disease, answered on behalf of Penn Medicine

  There are very few side effects to using nicotine gum or lozenges if they are used correctly. The gum should be chewed until soft and parked between the cheek and gums. Lozenges should be parked under the tongue. Some people experience mouth soreness, hiccups or heartburn when they first start using nicotine gum or lozenge. This might be a sign that the dose is too high, or that the technique might need some adjustment.

• QWhat are the risks of using nicotine replacement products?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  When using nicotine lozenges, gum, skin patches, inhalers, and nasal spray, you risk having an allergic reaction or experiencing some side effects, which can range from mild to severe. If you smoke while using a nicotine replacement product, you run the risk of a nicotine overdose. There is also a risk that using a nicotine replacement product might cause a pre-existing medical condition to worsen. However, you may be able to address this risk by choosing a specific kind of nicotine product that can best be used with your condition. For example, if you have mouth or dental problems, you might choose a nicotine patch rather than nicotine gum or lozenges.
• QCan tobacco lozenges and pouches help me quit smoking cigarettes?

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  A Dr. Vincent T DeVita Jr , Oncology, answered

  Lozenges that contain tobacco (like Ariva and Interval), and small, pouches of tobacco (like Revel and Exalt) are being sold as other ways for smokers to get nicotine in places where smoking is not allowed. The FDA has ruled that these are types of oral tobacco products much like snuff and chew, and are not smoking cessation aids. There is no evidence that these products can help a person quit smoking. Unlike scientifically proven treatments with known effects, such as nicotine replacement products, anti-depressants, nicotine receptor blockers, or behavioral therapy, these oral tobacco products have never been tested to see if they can help people quit tobacco.
  We know that oral tobacco products such as snuff and chewing tobacco contain human carcinogens. These products cause mouth cancer and gum disease. They also destroy the bone sockets around teeth and can cause teeth to fall out. There are studies showing potential harmful effects on the heart and circulation, as well as increased risks of other cancers. They also cause bad breath and stain the teeth.
• QAre there any risks in taking nicotine replacement therapy?

  1 Answer

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  The greatest risk involved in nicotine replacement therapy occurs if you continue smoking. When that occurs, nicotine can accumulate in the body at toxic levels. Nicotine replacement therapy can also have negative interactions with other medications, including Aplenzine, Budeprion SR or XL, Buproprion Hydrobromide or SR, Buproban, Wellbutrin, and Zyban.
• QWhat are the side effects of nicotine replacement therapy?

  4 Answers

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  A Dr. Darria Long Gillespie, MD , Emergency Medicine, answered

  Side effects may include headaches, dizziness, irritability, insomnia, weakness, numbness and tingling, palpitations, cough, shortness of breath, indigestion, nausea, vomiting, diarrhea, muscle and joint pain, menstrual problems, oral ulcers, changes in taste, and irritation of eyes, nose, mouth, throat, or sinuses. Skin irritation, redness, swelling, and allergic reactions have been associated with the nicotine patch. 
  
  This answer was adapted from Sharecare's award-winning AskMD app. Start a consultation now to find out what's causing your symptoms, learn how to manage a condition, or find a doctor. 

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• QWho should use nicotine replacement therapy?

  1 Answer

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  Nicotine replacement therapy should be used by people who smoke more than 15 cigarettes per day and who want to quit. It can also be used by smokeless tobacco users. Nicotine replacement therapy makes permanent smoking cessation ten times more likely.
• QHow does nicotine nasal spray interact with other drugs or food?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  Nicotine nasal spray can affect other medications that you take on a regular basis. Stopping or starting smoking can also have this effect on medications. Talk to your doctor if you are taking the following medications: acetaminophen, imipramine, beta blockers, oxazepam, labetalol, prazosin, theophylline, pentazocine, insulin, isoproterenol, oxymetazoline, phenylephrine, or products containing caffeine. Do not smoke while using this product. There may be other drugs that interact with nicotine nasal spray. Inform your doctor about any prescription, over-the-counter drugs, or nutritional or herbal supplements you are taking.
  
• QWhat should I do if nicotine gum doesn't work to help me quit smoking?

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  A Penn Medicine answered

  When the gum is not as effective as it can be, it is usually for one of two reasons. First, if you are using it like chewing gum, it will not work. It has to be placed between the cheek and gum for the nicotine to be absorbed. Second, don't be afraid to use enough. In the first few weeks of quitting, you can use 1 piece every hour.

• QShould I let my doctor know I am using nicotine replacement therapy?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  You should let your doctor know if you are using nicotine replacement therapy. In some cases, the products can interact with medications you may be taking. Also, only a doctor can prescribe some forms of nicotine replacement therapy, including nasal sprays and inhalers.