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Medications and Myths - F.A.Q.'s

Dr_Hurt
Mayo Clinic
1 14 299

Blog

“Why should I use the nicotine patch, inhaler, gum, lozenge, or spray?  Why merely substitute one form of nicotine for another?

Many people worry about trying the Nicotine Replacement Therapies (NRT’s) because they feel that when they stop smoking, they should be stopping all nicotine. 

It’s important to know that nicotine is not the harmful substance in tobacco.  Nicotine is the addictive substance – but not the harmful substance.  When you inhale tobacco smoke you inhale thousands of chemicals including carbon monoxide, polonium 210, arsenic, benzo[a]pyrene, and nitrosamines specific to tobacco.  Over 60 of the chemicals found in tobacco smoke are known to cause cancer. 

When you take nicotine replacement medication to alleviate withdrawal and reduce craving for cigarettes, you are not taking in the chemicals that cause health problems. 

“So, what if I try to quit smoking by using the patch, and then I have a cigarette?” 

Smoking while on the patch probably means that you need more nicotine replacement.  You need to decide where you are going to get your nicotine, from the very harmful cigarette or the relatively safe replacement medication.  Your best bet is to set a stop date, and use the right amount of nicotine replacement so that you can effectively manage the desire to smoke.

“I am concerned about taking two or more nicotine replacement medications together.  The product inserts warn consumers not to.”

Yes, the product inserts in the United States do say that, but a number of studies have shown that people can use more than one nicotine replacement medication safely and using more than one will increase the likelihood for success in stopping smoking.  For example, we recommend using the nicotine patch as a base medication (because it delivers nicotine over a period of almost a day) to alleviate withdrawal symptoms and then add a shorter acting nicotine replacement like the nicotine inhaler or nicotine lozenge for trigger situations – like in the morning, with coffee, when driving, or for stressful times which can provoke urges to smoke.

“But how do I ever get off of the nicotine if I stop smoking – but then use NRT’s?”

Nicotine replacement products do not give you the high dose of nicotine that you get with the cigarette.  And, gently weaning off of the NRT over a period of 3-6 months will generally be much more comfortable than you might think.  For over time, as you use nicotine replacement rather than cigarettes, your nicotine receptors in your brain will become accustomed to the lower dose of nicotine, and begin to calm down – making it much easier to stop using nicotine replacement than it is to stop smoking.

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About the Author
Retired in 2014. Dr. Richard D. Hurt is an internationally recognized expert on tobacco dependence. A native of Murray, Kentucky, he joined Mayo Clinic in 1976 and is now a Professor of Medicine at its College of Medicine. In 1988, he founded the Mayo Clinic Nicotine Dependence Center and since then its staff has treated more than 50,000 patients for tobacco dependence.