Nicotine products

About nicotine products

Nicotine is a drug that is inhaled from the tobacco in cigarettes. It gets into the bloodstream and stimulates the brain.
Nicotine products are a way of getting nicotine into the bloodstream without smoking. You can buy these from pharmacies and other retail outlets. They are also available on prescription or through local NHS stop smoking schemes.
Nicotine products stop, or reduce, the symptoms of nicotine withdrawal. This helps you to stop smoking, but without having unpleasant withdrawal symptoms. Nicotine products do not 'make' you stop smoking. You still need determination to succeed in breaking the smoking habit.

Before using nicotine products

As a rule, getting nicotine from nicotine products is much safer than from cigarettes. (Nicotine products do not contain the harmful chemicals that cigarettes have).
Tell your doctor or healthcare professional if you are taking or have recently taken any other medicines, including those obtained without a prescription.

Pregnancy
Nicotine products are likely to be safer than smoking and so their use can be justified in pregnant women who are finding it difficult to stop smoking. Nicotine products that are taken when required (such as gum, lozenge, spray, inhalator) are preferred to patches. This is to minimise the exposure of nicotine to the unborn baby.
Breastfeeding
The amount of nicotine that gets into breastmilk is probably similar whether the mother smokes or uses nicotine products. Breastfeeding within one hour of smoking or taking a nicotine product can significantly increase the levels of nicotine in breast milk. Therefore, nicotine products that are taken intermittently are probably best if nicotine products are used during breastfeeding. Avoid using the nicotine product for at least one hour before breastfeeding.

How to use nicotine products

Nicotine gum
Different strengths are available. You should use the 4mg strength if you smoke 18 or more cigarettes a day. You need about 12-15 pieces of gum per day to start with (about one per hour). To release the nicotine, chew the gum slowly until the taste is strong. Then rest it between the cheek and the gum to allow absorption of nicotine into the bloodstream. Chew the gum again when the taste fades, and rest it again when the taste is strong, etc. Use a fresh piece of gum after about an hour.
After 2-3 months you should use the gum less and less. For example, reduce the chewing time, cut the gum into smaller pieces, or alternate the nicotine gum with sugar-free gum. Gradually stop the gum completely.
The disadvantage of gum is that some people do not like the taste, or always having something in their mouth. Gum is not suitable if you wear dentures.
Nicotine patches
The patches come in different strengths. The manufacturers normally recommend that you gradually reduce the strength of the patch over time before stopping completely.
A nicotine patch stuck onto the skin releases nicotine into the bloodstream. Apply one patch each day to dry, non-hairy skin on the hip, chest or upper arm. Some patches work for 16 hours and are worn during waking hours and removed at bedtime. Some patches work for 24 hours and worn day and night. Site the next days' patch on a different area. Patches are discreet, and easy to apply.
The disadvantage of patches is that a steady amount of nicotine is delivered. This does not mimic the alternate high and low levels of nicotine when you smoke, or with chewing nicotine gum.
Nicotine inhaler
This resembles a cigarette. Nicotine cartridges are inserted into a plastic holder, and inhaled in an action similar to smoking. Each cartridge provides up to three 20 minute sessions. You should use about 6-12 cartridges a day for eight weeks, and then gradually reduce over four further weeks. It is particularly suitable if you miss the hand-to-mouth movements of smoking.
Nicotine lozenges
If you are using the lozenges they should be placed in the mouth and allowed to dissolve (move the lozenge around from time to time), do not chew or swallow whole. Do not eat or drink while the lozenge is in the mouth.
Nicotine nasal spray
The nicotine in the spray is rapidly absorbed into the bloodstream from the nose. This form of nicotine product most closely mimics the rapid increase in nicotine level that you get from smoking cigarettes. This may help to relieve sudden surges of craving. As the nasal spray may cause sneezing and watering eyes for a short time after use, do not use it whilst driving.
Nicotine sublingual
If you are using the sublingual form of nicotine products, the tablet should be placed under the tongue and allowed to dissolve completely. Avoid swallowing until tablet is fully dissolved. You dissolve these under the tongue (they are not swallowed). Nicotine is absorbed through the mouth into the bloodstream.

Getting the most from your treatment

Remember that you will need determination and setting a "quit date" often helps.
Always read the manufacturer's printed information leaflet.
If you have any of the following conditions it is best to discuss with a doctor before using nicotine products:

• Severe heart problems
• Diabetes
• Stomach ulcers and problems (this only applies to products taken by mouth)
• Uncontrolled thyroid problems
• Liver or kidney problems

• Do not smoke while you are using nicotine replacement products. Doing so will increase side effects.
• If you are using the patches, never apply them to broken or infected skin.

Can nicotine products cause problems?

Along with their useful effects all medicines can cause unwanted side effects, which usually improve as your body adjusts to the new medicine. Speak with your doctor or pharmacist if any of the following side effects continue or become troublesome.

How to store nicotine products

• Keep all medicines out of the reach and sight of children.
• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines