When it comes to choosing nicotine replacement, there are several over the counter (OTC) and prescription only options available. Nicotine patches, gum and lozenges are available OTC. Nicotine patches are available in 21 mg, 14 mg, and 7 mg of nicotine per dose. Nasal spray is available via prescription only from a healthcare provider. Each cartridge in the Nicotrol inhaler delivers on average 4 mg of nicotine. Each nasal spray bottle contains 100 mg of nicotine and an average of 40 sprays per bottle at 1 mg per dose (1 spray in each nostril).
The Nicotrol inhaler, another form of NRT, was discontinued in 2023. The product was discontinued due to unavailability of an essential resin used to produce the inhaler mouthpiece.
A cigarette on average delivers 2-3 mg of nicotine. Your body needs around this much nicotine replacement for every cigarette smoked to help relieve withdrawal symptoms and cravings after quitting smoking.
[3 mg nicotine x average number of cigarettes smoked per day = ___ amount of nicotine replacement needed per day]
Using this formula, a person who smokes on average 10 cigarettes daily and looking to use nicotine replacement would need 30 mg of nicotine replacement every day after quitting for the first few weeks to manage cravings and withdrawal symptoms. This could look like having one 14 mg patch on and taking eight 2 mg nicotine lozenges or a combination of different nicotine replacement products that add up to a total of around 30 mg of nicotine daily. Underdosing with nicotine has been shown to be associated with higher risk for relapse to smoking.
Your health care provider might take into consideration other variables such as blood pressure, existing medical conditions, and any current medication which may alter the amount of nicotine replacement recommended for you daily by your provider. If you are preparing for surgeries or any procedures, some physicians do ask that you refrain from all nicotine products so please consult with your health care provider to determine what might be the ideal amount of nicotine replacement for you. If you are getting too much nicotine, the symptoms you would notice are dizziness and nauseousness - which would just tell you that you need to decrease your dosage of nicotine replacement.
When it comes to choosing the right nicotine replacement, it really comes down to what you would find effective in helping manage cravings. For example, some like the gum and or lozenges while others might not want anything in their mouth and would prefer patches only. Cost might be another factor that goes into helping you decide which option works best. It certainly is not a one size fits all scenario, so it’s important to try different products to figure out if one suits you better than another.
What nicotine replacement products have you used to help with quitting?
Dhivyaa Manickam, M. A.
Counselor / CTTS
Photo by Nic Y-C