Most people who smoke become addicted to the nicotine content in tobacco. When you try to quit you will experience a craving for nicotine which causes withdrawal symptoms. There are products available to help you give up smoking and they are designed to help with this problem. NOTE: Products to help quit smoking are most effective when combined with behaviour therapy or counselling.
If you want to quit smoking you may need to access some anti-smoking aids to support your journey to becoming a non-smoker.
Prescription medicines are available (and in many cases subsidised) on the Australian market and the Pharmaceutical Benefits Scheme. It is important that you discuss your treatment options with your doctors or pharmacist and a prescription from your GP will be required for any prescription medicines to aid quitting smoking.
Quit smoking products available on prescription generally work by either blocking the nicotine receptors in the brain or stimulating the nicotine receptors in the brain (however less so than nicotine itself). Thus, they help to alleviate the withdrawal effects of quitting smoking and reduce the pleasurable effects that nicotine has on the brain and body.
NOTE: These medicines may not be suitable for all people and it is important to consult your doctor and pharmacist to ensure these treatment options are right for you and to ensure the side effect profile of the medicine is acceptable and that there are no interactions with other medicines that need to be considered.
Nicotine Replacement Therapy (NRT)
This form of therapy does not require a medical prescription and provides smaller doses of nicotine to help reduce withdrawal symptoms while you learn to live without cigarettes. Nicotine is delivered to the blood stream more slowly, at lower doses and in more constant concentrations than cigarettes.
When using NRT it is important that you replace cigarettes with the NRT and do not continue to smoke. Usually once the physical, psychological and social aspects of smoking have been overcome, you should not find it difficult to give up the NRT. If you really want to stop smoking, you are twice as likely to succeed in giving up with the help of NRT. This means that up to 1 in 5 smokers who want to stop will do it with the help of NRT. A combination of NRT with support or counselling gives the best chance of success.
Types of NRT
Doses of 2mg and 4mg are available – the dose of nicotine gum to be used depends on the smoking habits of the person concerned. The gum is used when the urge to smoke is felt.
The gum is chewed slowly until a strong taste or a slight tingling sensation is felt and then placed under the tongue or between the cheek and gums until the taste or tingling sensation disappears. This process is then repeated until the nicotine effect is no longer experienced – usually around 30 minutes.
No more than 40mg (2mg x 20 pieces or 4mg x 10 pieces) should be used in one day. The dose is gradually reduced over time. The gum should not be used continually for a period of more than one year. Ask your Doctor or Pharmacist about contraindications/precautions/interactions information for these products.
These are also called nicotine transdermal devices and are available in differing strengths of high, medium and low nicotine. The treatment period varies depending on the brand of patch chosen and lasts between 8 and 16 weeks.
The patch should be applied to a hairless area of the upper body or to the upper arm. It should be replaced daily or at bedtime if a 16-hour patch is chosen and skin sites should not be reused for a week.
If symptoms of overdose develop, the patch should be removed from the skin and the area washed with water. (Soap will increase nicotine absorption). Because nicotine can be readily lost from the patch by evaporation, patches must not be removed from their protective pouches until immediately prior to their use. Ask your Doctor or Pharmacist about contraindications/precautions/interactions information for these products.
Doses of 2mg and 4mg are available. The ‘Time to First Cigarette’ (TTFC) test is used to determine a smoker’s level of dependence and corresponding dosage selection. Smokers who have their first cigarette within 30 minutes of waking up are considered to be highly dependent and the 4mg lozenge is recommended for them. The 2mg lozenge is recommended for smokers who wait more than 30 minutes after waking before having a cigarette.
Lozenges are put in the mouth and are sucked like any other lozenge and moved around the mouth periodically, until completely dissolved. The lozenge should not be chewed. The dose is reduced gradually by reducing the number of lozenges taken each day. Ask your Doctor or Pharmacist about contraindications/precautions/interactions information for this product.
Nicotine inhalers and Mist Sprays
These plastic smokeless devices, in the shape of a cigarette, are designed to provide the hand-to-mouth action you may miss, when giving up smoking. The device has a cartridge impregnated with nicotine and menthol and is inhaled in the same way a cigarette is inhaled. The nicotine runs out when there is no taste of menthol in the mouth when inhaling. The cartridge may be replaced after this time.
It is recommended that 6-12 cartridges be used per day over a 3-month treatment period. This is followed by dosage reduction over 6-8 weeks. Ask your Doctor or Pharmacist about contraindications/precautions/interactions information for this product.
Nicotine mist products deliver a rapidly absorbed dose of nicotine by spray into the mouth and are a fast convenient way to help aid your quit smoking journey.
Quitline is a telephone information and advice or counselling service for people who want to quit smoking.
You can phone the Quitline on 13 7848 confidentially from anywhere in Australia for the cost of a local call only.
Ask your Pharmacist for advice.
- If you want to give up smoking ask your Pharmacist for suggestions. Your Pharmacist may suggest a nicotine replacement product and advise you about stop smoking services available locally.
- If after a week or two you are still suffering cravings or withdrawal symptoms, your Pharmacist might suggest you see your Doctor for advice on increasing the dosage of the nicotine replacement product or changing the product you are using.
- If the diet is inadequate, consider some supplements. Smoking is a leading cause of ‘oxidative stress’ in the body. This is an imbalance between the production of unhealthy free radical molecules and healthy antioxidant substances. Antioxidant supplements that my be advisable for smokers to take include vitamin C, co-enzyme Q10, vitamin E and grapeseed extract. See the antioxidants topic for more information.
DISCLAIMER: This information is an educational aid only. It is not intended to replace medical advice for individual conditions or treatments. Talk to your doctor, pharmacist, nurse or naturopath before following any medical regimen to see whether it is safe and effective for you.