You can chew it, suck it, inhale it or slap it on your arm — whichever way you want to try, nicotine replacement therapy can be an effective weapon in your fight to quit smoking.
Not that anything is foolproof. Last year, President Obama reportedly fell off the stop-smoking wagon although he was chewing nicotine gum. And he's far from alone. But some smokers find that getting a steady dose of nicotine helps them conquer the withdrawal symptoms from quitting and helps them stay cigarette-free.
More than 70 percent of smokers say they want to quit. But one in five adults in the U.S. — 45 million — continue to smoke, according to the American Lung Association's 2010 report on trends. And while most age groups saw a decline in the percentage of smokers over time, the 45-to-64 age group actually saw in increase in the percentage of smokers — 17.2 percent in 2008, up from 15.9 percent in 1965.
The U.S. Public Health Service has developed a Clinical Practice Guideline on the most effective ways to stop smoking. It recommends seven medications approved by the Food and Drug Administration, five of which are nicotine replacement therapies.
Three are sold over the counter:
- Gum - Nicorette, Nicorelief, Nicotine Polacrilex
- Patch - Nicoderm CQ, NTS Nicotrol
- Lozenge - Commit
And two are available only with a prescription:
- Inhaler - Nicotrol inhaler
- Nasal spray - Nicotrol NS
The other two medications are Bupropion (Zyban), an anti-depressant that helps with withdrawal and Varenicline (Chantix) which alters the nicotine receptors in the brain.
Some studies show that for best results, nicotine replacement therapies should be used in combination. As reported by the National Institutes of Health, a study by scientists at the University of Wisconsin-Madison compared the relative effectiveness of medications in a group of 1,500 smokers who wanted to quit. Participants received either the nicotine patch, the nicotine lozenge, bupropion, a combination of the patch plus the lozenge or a combination of the lozenge plus bupropion. They also received six individual counseling sessions.
"In the November 2009 issue of the Archives of General Psychiatry, the scientists reported that about 40% of those in the patch-plus-lozenge group were still smoke-free 6 months after their quit dates. The success rates in the 4 other treatment groups were around 33% and about 22% in the placebo group."
What's more, after making some statistical corrections, only the patch-plus-lozenge combo was more effective than a placebo after six months.
Another study by researchers at the University of Pennsylvania found that smokers might need to use nicotine therapy longer than the eight weeks that manufacturers recommend. At the end of the 24-week study, smokers who used a nicotine patch throughout the whole trial were about two times as likely to succeed in their quitting attempts than those who received a placebo patch after the eighth week of the study. Unfortunately, though, in a year follow-up the relapse rate was the same, with only 14 percent still abstaining.
For best results, say experts, use nicotine replacement therapy along with counseling, group support or other smoking cessation program.