Rationale for Using Nicotine Replacement Medications

Blog Post created by dr.hurt on Nov 13, 2009

Those trying to stop smoking are often puzzled by the use of nicotine replacement therapy while trying to quit smoking.  “Why am I using nicotine when I want to get off nicotine?”

This question is a good one, and deserves some explanation.

When a person starts smoking, the nicotinic receptors in the brain are activated – forever changing the brain chemistry.  And as an individual smokes more heavily – more of these receptors are excited.  Thus, the smoker becomes more tolerant to nicotine – meaning they need more nicotine to reach the same level of pleasure.  For example at age 16, perhaps you may have only smoked 5 cigarettes per day, but by age 20 you were smoking 20 cigarettes per day.  By increasing the amount of nicotine per day – you also activated more of these receptors.  Thus, your tolerance for nicotine became greater, and you needed more nicotine to satisfy these additional receptors.  If you don’t, withdrawal symptoms and cravings occur.  To learn more, go to re-learn addiction at BecomeAnEX.org.

Nicotine replacement therapy (NRT) will help with the withdrawal symptoms but the amount of nicotine delivered by these products is much less than by cigarettes.  The health concern with smoking isn’t the nicotine – it is all the other components in the tobacco as well as the cigarette smoke.  There are over 4,000 compounds in cigarette smoke and over 60 of them can cause cancer.

Remember those withdrawal symptoms (e.g., irritability and nervousness) you experienced when you have tried to quit in the past that made it almost impossible to stay quit?  By using NRTs or other approved medications you are buying yourself some healthy time while you are getting new behaviors in place.

And what about those non-nicotine medications used to treat tobacco dependence – like varenicline (Chantix) or bupropion (Zyban or Wellbutrin)?  Again, these are not nicotine but another drug which acts on the nicotinic receptors in a different way than nicotine replacement.  Both increase your chances of stopping smoking. In summary, we use NRT or other medications to satisfy those nicotine receptors - which, in turn, put the withdrawal symptoms at bay while we work on re-learning life without cigarettes.  Go to BecomeAnEX.org to learn more about NRTs and how they will help you with your EX plan.