Nasal sprays, Patch, Gum and Inhalers
Nasal sprays help reduce nicotine withdrawal symptoms. With one spray into each nostril, a total of 1 milligram of nicotine is released, allowing you the nicotine level necessary to ease your withdrawal symptoms while you are quitting. Nasal spray is absorbed through the nasal membranes. Remember, it is important not to inhale or sniff while using the spray. The nasal spray will take some getting used to. Like all prescription drugs, nasal spray may cause side effects. During the first week or so, most people experience the following side effects: hot, peppery feeling in the back of the throat or nose, sneezing, coughing, watery eyes, or a runny nose. Using the nasal spray regularly for the first week and following the instructions exactly will help you adapt to the spray. The nasal spray is not for everyone. Patients who are pregnant or nursing, or have chronic nasal problems, heart problems, stomach ulcers, overactive thyroid, high blood pressure, allergies to drugs, diabetes requiring insulin, a kidney or liver disease, or wheezing/asthma should consult their doctor before using the spray. Also, if you are taking any prescription medication or are under a doctor's care for any condition, you should first discuss with your doctor the potential risks of this product. Because the spray contains nicotine, it is possible to become dependent on the nasal spray. Only use the spray when you are having nicotine cravings to overcome the addiction.
Transdermal nicotine patch
Nicotine patches work by getting nicotine into your bloodstream through your skin. They are designed to release the nicotine at a constant rate so that you will not experience cravings as frequently as with other methods. The goal is that you can use the patch to keep cravings at bay while you focus on the behaviors associated with nicotine use and reduce the triggers that make you want to use tobacco. Most people have a greater success rate if they gradually (slowly) reduce the strength of the patch being used over a period of weeks. The strength of the patch needs to be adjusted to your needs by assessing your use of nicotine and your general health. It is important that you do not smoke while using the patches. Some people experience unusual dreams while taking this medication. Additional side effects can be discussed during your smoking cessation counseling session.
Tips on using the transdermal patches
Put the patch on after bathing at the same time each day. Remember to remove the old one before putting on the new patch.
Change the place where you put the patch. You can use the diagram included to give you some suggestions.
It is helpful to write down where you put the patch so you remember to give that site a rest for 3-5 days
before putting a new one on that site.
Write the date on the patch when you apply so you make sure that each patch is removed.
If you find that a patch has come off, put on a new one.
Do not take the patch off at bedtime unless you are instructed to do so by your physician.
Read the instructions that come with your patches and follow them. If you have questions, please discuss them with your doctor or nurse.
Do not apply the patch to a site that has been recently shaved.
When you take the patch off, fold it placing the sticky sides together. Keep these out of reach of children and pets.
If your skin is irritated and sore where the patch was, use a small amount of hydrocortisone cream on the site. This can be bought at any drug store without a prescription.
If you experience other problems, contact your pharmacist or doctor.
Nicorette (Nicotine Polacrilex)
Nicorette is a tool to help people stop using nicotine by giving a small dose of nicotine through the lining of the cheeks. Nicorette is not to be used like chewing gum. Guidelines for using Nicorette are as follows:
DO NOT SMOKE OR USE OTHER NICOTINE PRODUCTS WHILE USING NICORETTE.
Plan to use the gum on a regular basis to keep the blood levels more constant, which may help to avoid
some of the cravings. One piece each hour is a place to start.
Bite gum a few times until a tingling sensation is felt or you taste the nicotine.
Stop biting and hold gum next to your cheek toward the front of your mouth. Do not chew Nicorette as you would chewing gum.
When you no longer notice a tingling sensation, repeat steps 3 & 4, moving the gum to a different part of
Continue the process of biting and holding the gum until it becomes hard and loses its flavor. This usually takes about 30 minutes. Throw out the gum at this point.
Do not eat or drink anything while using the gum. Any nicotine that is swallowed with saliva or washed down with liquids will not be effective and may cause an upset stomach, heartburn and/or nausea.
Avoid acidic beverages before using the gum. If you have had coffee, cola, orange juice or other acidic
liquids, rinse your mouth with water before using the gum.
Do not swallow the gum.
Keep the gum out of reach of children and pets at all times.
Tapering off the gum will vary for each person. Remember that Nicorette is only one tool to help you stop using nicotine and that use of a number of tools increases the chance that you will not start again. It is common to use the gum for several weeks to a few months before you are ready to stop completely.
The inhaler helps you control the amount of nicotine you need when the urge to smoke hits. By holding the inhaler between your fingers and puffing on it, you'll get the nicotine that your body needs, delivered in a way
that can help ease your withdrawal symptoms while you are quitting. As you inhale or puff through the
mouthpiece, nicotine turns into a vapor and is absorbed into your mouth and throat. What the inhaler leaves out are the harmful tars, carbon monoxide, and the smoke of a cigarette.
Use the inhaler longer and more often at first to help control cigarette cravings. Less nicotine per puff is released when you use the inhaler versus a cigarette. The inhaler uses nicotine cartridges that provide about 20 minutes of active puffing, or approximately 80 deep draws or about 300 shallow puffs. Guidelines for using the Inhaler are as follows:
Be aware that the number of inhaler cartridges varies per person, and that your doctor may adjust the
number of cartridges you use during the first few weeks.
The recommended usage is between 6 and 16 cartridges a day, with frequent continuous puffing (20
As your body adjusts to not smoking, your doctor will either tell you to stop using the inhaler or to slowly
reduce the dose.
Do not use more than 16 cartridges each day unless directed to do so by your doctor.
The recommended treatment is up to three months and, if needed, a gradual reduction over the next 6-12 weeks.
Total treatment should not exceed six months.
Avoid using coffee, tea, soda or acidic juices 15 minutes before using the inhaler or while puffing on the
inhaler. The inhaler might not be for everybody. If you are pregnant or nursing, you are encouraged to try other methods
to quit smoking, like educational or behavior changing programs, because nicotine in any form can cause harm to your unborn baby.
Also, patients with heart problems, stomach ulcers, an overactive thyroid, high blood pressure, allergies to drugs, diabetes requiring insulin, a kidney or liver disease, or wheezing/asthma should talk with their doctor first before using the inhaler. Remember, only you and your doctor can decide if the benefits of using the inhaler to stop smoking outweigh the risk of using this medicine.
University of Illinois at Urbana-Champaign
Tacoma-Pierce County Health Department, 2002.