Nicotine replacement therapy (NRT)

Nicotine replacement therapy, often known as NRT, is a way of weaning a smoker off cigarettes and tobacco by providing lower doses of nicotine.

Nicotine is the substance smokers become addicted to. When quitting smoking, the body has a craving for nicotine, which can make it harder to quit.

By providing a safer controlled dose of nicotine with NRT, cravings can be managed better, leading to a greater chance of quitting successfully.

A major review of 150 trials of NRT published by the Cochrane Library found evidence that NRT made it more likely a smoker would succeed in an attempt to quit. The chances of succeeding increased by 50 to 70% with NRT.

NRT duration

A course of nicotine replacement therapy is usually around eight to 12 weeks. Then the dose starts to be reduced before NRT is stopped after around three months. Heavier smokers may need a longer NRT therapy time.

Because of the way nicotine gets into the body from NRT and the duration of treatment, people are unlikely to become addicted to it.

Types of NRT

NRT products are available either free from the NHS, on prescription from a GP or over the counter from a pharmacy. Even if you have to pay for the treatment, it is usually far cheaper than the cost of smoking.

NRT is available as skin patches, chewing gum, cigarette-style inhalators, under-the- tongue tablets or lozenges, nasal spray or mouth spray.

All types of NRT appear to work equally as well, so the choice is a personal one. It is possible to use a combination of products within a safe overall dose.

Side effects of NRT

NRT can cause side effects, including skin irritation from patches, irritation of the nose, throat or eyes from nasal sprays, disturbed sleep, unusual dreams, upset stomach, dizziness and headaches.

It is best to quit smoking without NRT when pregnant and breastfeeding. However, a doctor may recommend NRT as being less dangerous to the baby than the chemicals in tobacco smoke.

The NHS says it is a myth that NRT causes cancer. Tar and carbon monoxide are among the toxic chemicals in tobacco that cause the damage, not the nicotine.

NRT can increase the heart rate and blood pressure, so people with heart conditions should check with their GP before starting nicotine replacement therapy.

Nicotine affects blood sugar levels, so people with diabetes using NRT should check their glucose levels regularly.