Nicotine causes mental as well as physical addiction. In order to ease up the physical withdrawal symptoms, there are nicotine replacement therapies (NRT) available such as patches, gums and tablets. The benefit of these products is that they release nicotine the body craves without the other toxic substances that cigarettes do. This makes stopping smoking easier mentally as well.

According to research, the likelihood of quitting smoking completely is twice as high on those who decide to use NRT compared those who don’t. Thus, these products are very effective.

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NRT in stopping smoking

Different nicotine replacement therapies (patches, gums and tablets) lessen the withdrawal symptoms and desire to smoke and thus, make it easier to stop smoking.1 The desire to smoke is the reason why many cannot quit smoking. If you are thinking of quitting, keep in mind that some manage it without these products but the success rate on the first try is quite low.

Trying to quit many times is not unheard-of but rather a part of the process. Many relapse during the first three months. Often times these relapses happen because of the withdrawal symptoms. The different options for NRT improve the person’s ability to permanently get rid of tobacco.

Types of NRT

NRT only helps to combat the physical withdrawal symptoms caused by smoking cessation. It is, therefore, advisable to combine the use of these products with the tools that focus on the mental aspect of smoking cessation.

In order to maximize the chances of success, the NRT should be used as soon as the decision to quit is made. The most famous products are nicotine patches, gums, lozenges but there are also inhalers and nasal sprays available. Electric cigarettes can also be used as an alternative to quitting smoking even though they are not officially recommended.

Nicotine patches

There is no proof that the nicotine patches would be more effective or better than nicotine gums or lozenges. The choice often depends on your own preferences and thus, many turn to the patches because they are easy to use. They should be placed on the skin and left on until the next day. There are variations between the patches, some are used for 24 hours and some taken off at night, check the packaging for more.

A good time to place on a new patch is in the morning when you have woken up. Suitable places for the patch is upper arm, upper back and hip. The skin covered by the patch should be dry and hairless. It is advisable to place the patch on the skin evenly to allow it to stick properly and last all day long. The next patch should be attached to a different location on the skin and the same location can be used the earliest after one week.

When the patch is attached to skin it starts to release nicotine. The benefit of the patch is that it releases nicotine evenly throughout the day. This is why they are suitable for people who used to smoke a lot and received nicotine steadily throughout the day. The probability that the user would get addicted to patches instead is very low. The longterm use doesn’t cause negative effects but it is of no use.

Side effects

Nicotine patches rarely cause any side effects. Sometimes the skin might appear slightly red or swollen which can be an indication of an allergic reaction. These reactions are usually mild and disappear after a day. If this is not the case you should stop using them.

Possible side effects: 

  • headache
  • anxiety
  • dizziness
  • insomnia
  • constipation
  • nausea
  • diarrhoea
  • muscle ache
  • weakened taste 

Possible rare side effects:

  • migraine
  • palpitations
  • chest pains
  • stomach pain
  • digestive problems
  • heartburn 
  • muscle cramps
  • increased sweating 

All possible contraindications with other medicines are not known but as a general rule, you shouldn’t use these patches on your own if you have undergone a heart attack, stroke or if you have any of the following:

  • cardiac arrhythmias 
  • collapsed coronary arteries
  • skin’s hypersensitivity to nicotine
  • chronic skin diseases such as psoriasis, rash or dermatitis.

If you have suffered any of the aforementioned before you should have a talk with your doctor if you can use the patches safely.


In order to avoid a possible overdose, you should read the instructions very carefully. Usually, the dosage depends on your own history with smoking. The more you have smoked, the stronger nicotine patch you will need. If you have smoked more than 20 cigarettes per day, you should start from the stronger version of the nicotine patch and use it for 3-4 weeks before switching to a medium strength patch. The medium type is also used for 3-4 weeks before switching to a mild one for another 3-4 weeks.

If you have smoked less than 20 cigarettes per day, you should start the treatment with a medium strength patch and use it for 3-8 weeks. After this period you can switch to a mild patch for another 3-8 weeks.

If you are pregnant it is advisable to stop smoking without the help of NRT because you shouldn’t have any nicotine in your bloodstream. If you are finding it hard to stop smoking you can discuss with your doctor if you can use nicotine patches during your pregnancy. Read more about the harms of smoking while pregnant.


Nicotine patches can be bought over the counter or from the internet without a prescription. The price varies between the size of the packaging and the brand but the treatment as a whole can cost around a few hundred pounds depending on how long you want to use them for.

Nicotine gums

Nicotine gums are slightly more troublesome compared to nicotine patches that are placed on the skin only once per day. The benefit of the gum is that it is more likely to prevent weight loss as a consequence after quitting smoking. Read more about quitting smoking and weight loss.

Nicotine gums come in a variety of tastes and its regular taste is similar to a normal gum. It is recommended to be used once every hour but no more than 16 times per day. The amount should be lowered when the addiction eases up and time passes as it is only a temporary aid.

The gum should be chewed slowly around 30 minutes at a time so that nicotine can travel through the mucous membrane into the bloodstream. If you chew the gum too fast not all of the nicotine will absorb. One way to avoid this is to keep on chewing until it starts to taste like nicotine and then leave it against your cheek until the taste becomes weaker. After this, you can continue to chew. The instructions are also on the packaging so you can refer to them in any case of uncertainty.


Just like with nicotine patches, the right dosage depends on how much you have smoked in the past. There are 2 mg and 4 mg dosages available. 2 mg is for those who are used to smoking 20 cigarettes per day and 4 mg for those who are used to smoking 30 cigarettes per day. If you have smoked between 20-30 cigarettes per day you can decide which dosage is suitable for you. After a month of using nicotine gums, you should decrease the daily dosage and increase the time between dosages. You should never use the treatment for more than half a year.

Side effects

It is relatively rare that a nicotine gum would provide any side effects but if it does, it is one of the following:

  • headache
  • dizziness
  • constipation
  • diarrhoea
  • stomach ache
  • hickup 
  • nausea
  • vomiting
  • pain on the chin

In rare occurances: 

  • palpitations
  • arrhythmia
  • rash
  • allergic reactions

Nicotine gum can sometimes get stuck on dentures if you happen to have them.

In addition, it is not recommended to use nicotine gums if you smoke every now and then or if you don’t smoke at all as it can lead to overdose.


Nicotine gum is usually less expensive than nicotine patches. This is at least the case after the start of the treatment when you don’t have to take 16 gums daily. Nicotine gum is also a cheaper option than hypnosis, acupuncture or stop smoking medications such as Champix. Around 100 2mg nicotine gums cost around 20 pounds and 4 mg around 25 pounds.


The third popular NRT alternative is a lozenge. They are sugar-like pills that come in a variety of flavours. The benefit of the option is that they are more discreet than the aforementioned options. They are also said to aid in weight gain after quitting smoking by relieving food cravings. 

They come in 2 mg and 4 mg dosages and the mini lozenges come in the same dosage but in a smaller size. Just like with the gums and patches, your dosage depends on the extensivity of your habit. After the beginning, the dosage should be decreased and the addiction to ease up. The lozenges can taste much stronger than the gums. When this happens you can place it against your cheek to let the nicotine absorb into your bloodstream. It takes around 30 minutes for the lozenge to dissolve. They cost less than a pound per piece.


  1. NRT – MedlinePlus