Trying to decide on a short-acting nicotine replacement therapy (NRT)

Blog Post created by NDC_Team on Sep 16, 2020

When choosing the type of NRT you may use, think about which method will best fit your lifestyle and pattern of smoking or using smokeless tobacco. It is not a “one size fits all” when it comes to short-acting NRT and largely is personal preference. For example, are you looking for something to hold in your hand or to have in your mouth? Or do you want something that works rapidly?


There are currently 4 types of short-acting NRT: Nicotine gum, nicotine lozenges, nicotine nasal spray and nicotine inhaler (puffer)

  • Nicotine Gum: Looks similar to regular gum, other than containing nicotine the only real difference is that instead of constantly chewing the gum, nicotine gum is meant to be chewed until “gum like consistency” and the tucked between your gums and cheek, nicotine is then absorbed through the mucous membrane of your mouth. It comes in 2 mg and 4 mg strengths and can be purchased without a prescription.
  • Nicotine Lozenges: There are two sizes of lozenges that both come in the 2 mg and 4mg strengths. The mini lozenges are about the size of a tic-tac and the regular lozenges are about the size of a nickel. Smokers typically prefer the mini lozenges and smokeless tobacco users usually prefer the larger (or regular) size lozenges. The lozenges are not meant to be sucked on like a hard candy, but rather tucked between your gums and cheek, nicotine is then absorbed through the mucous membrane of your mouth. Lozenges can be purchased without a prescription.
  • Nicotine Inhalers (puffer): The nicotine inhaler is a thin plastic tube with a nicotine cartridge inside. Unlike other inhalers, which deliver most of the medicine to the lungs, the nicotine inhaler delivers most of the nicotine “vapor” to the mouth (puffing on, instead of inhaling). You can use the inhaler “like” a cigarette, by holding it between your fingers and putting the plastic tube on your lips. This can be very helpful if you are someone that is use to having a cigarette in your hand. Nicotine inhalers are by prescription only and remember the inhaler does not produce smoke or heat and it is not an E-cig.
  • Nicotine Nasal Spray: The fastest acting NRT product. The nicotine nasal spray is a little container with a small tip that is placed at the base of nostrils and you self-administer a small spray of nicotine. The nasal spray delivers nicotine to the bloodstream quickly because it’s absorbed through the nose. It relieves withdrawal symptoms very quickly and lets you control your nicotine cravings. Nicotine nasal spray is only available by prescription.


Here are a few things to consider when you are decided on NRT

  • Nicotine gums and lozenges are simple, discreet and fairly inexpensive.
  • Nicotine gum and lozenges are available over-the-counter.
  • Nicotine gums and lozenges are generally sugar-free.
  • Nicotine nasal spray works very quickly when you need it.
  • Nicotine inhalers allow you to mimic the use of cigarettes by puffing and holding the inhaler.
  • Both inhalers and nasal sprays require a doctor’s prescription.
  • If insurance does not cover the nicotine nasal spray or the inhaler, they both can be expensive.
  • Nicotine gum may stick to dentures or dental work making it hard to chew.

Laura McConahey

NDC Counselor/CTTS