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Coach Corner

How to Use NRT To Support Your Quit Efforts

April 6, 2022
By Pivot

Anyone who has tried to quit tobacco can list the tools they used that helped (or didn’t) along the way. When it comes to the topic of nicotine replacement therapy (NRT), many current and former tobacco users have a love-hate relationship. Maybe this sounds familiar!

The truth is that NRT can actually double your chances of quitting. But when it’s uncomfortable, confusing, or simply doesn’t work, it’s tempting to give up. Here are four ways NRT products can better support your quit efforts and work more effectively and comfortably, increasing the chances you’ll stick with them long enough to see real results!

Four ways NRT products can support your quit efforts

Understand nicotine vs. tobacco vs. NRT

When people struggle to quit using tobacco, it’s usually because of nicotine. Nicotine is a highly addictive chemical that creates feelings of focus and calm in the brain but produces stimulating effects in the body like anxiety and increased blood pressure. Nicotine occurs naturally in the tobacco plant, but commercial tobacco manufacturers add more to maximize the experience and ultimately cause dependence.

The pleasurable effects of nicotine wear off after a few minutes, beginning a cycle of withdrawal, craving, and repeated use. NRT can help you break the cycle by replacing most of the nicotine taken in from tobacco products with a controlled dose, free of the thousands of toxins in tobacco. This dose can be decreased gradually over time and eventually stopped.

All NRT products work in essentially the same way: nicotine is delivered through the skin into the bloodstream, where it travels to the brain and relieves symptoms of nicotine withdrawal.

Know that NRT is more than just patches and gum

Most people know about nicotine patches and gum, but NRT also includes lozenges, nasal spray, and a nicotine inhaler/puffer device. Each product has advantages and disadvantages. If you’ve tried NRT in the past and it didn’t seem to work for you, you may not have found the right product.

For example, someone with jaw problems may struggle to use the gum correctly but may benefit from a lozenge. If you have sensitive skin, a patch may be more irritating than helpful.

The inhaler is a great option for people who miss the hand-to-mouth action of smoking. It not only contains nicotine to relieve cravings but also keeps your mouth and hands busy.

If you don’t use tobacco every day or use it only in specific settings, you may benefit from “on-demand” products like nasal spray, the fastest-acting form of NRT.

When in doubt, read the instructions

All NRT products are technically medicines that come with directions on how to use them safely. People commonly use NRT the way it seems it should be used rather than how it is designed to be used.

For example, oral NRT products like gum and lozenges are NOT meant to be eaten like candy. One piece of gum is chewed until the nicotine inside is exposed. Then, it is parked between the gum and cheek so the active ingredient can get into the bloodstream through the skin in the mouth. It is periodically re-chewed and re-parked.

Chomping on nicotine gum like chewing gum – while tempting – can cause too much nicotine to enter the stomach, causing nausea or heartburn and not relieving the craving. Chewing more than one piece can cause too much nicotine to enter the bloodstream.

Make sure you’re getting the right dose

Another common error in using NRT is to use a dose that’s too low (or too high). In general, one cigarette equals approximately one mg of nicotine. If you smoke five cigarettes a day, a 21 mg (or Step One) patch would be too strong. But, if you smoke a pack a day, five or six pieces of gum or three hits from an inhaler a day would be too little.

The right dose of NRT should help you feel more like yourself – without tobacco. Any noticeable cravings should be manageable with distractions or substitutions. With the right dose, irritability and difficulty focusing should be barely noticeable. If they are, more nicotine replacement may be helpful.

On the other hand, too much nicotine is not healthy. Signs of getting too much nicotine include feeling dizzy, nauseous, light-headed, or jittery. When using a combination of patches and short-acting NRT, watch for these signs and reduce the short-acting products first. Getting the right dose can take some experimentation, but it’s worth it!

Settle in for a commitment

When people finally quit tobacco with the help of NRT, they often feel “home free” and stop altogether. But ending NRT treatment too early can cause withdrawal symptoms to begin again, creating a slippery slope back into tobacco use. Instead, think of NRT as a long-term commitment rather than a temporary bridge.

The standard schedule for each dosing level of NRT is around two to four weeks, but some people need longer to feel confident to step down or stop. Many people use NRT for several months before they have made the changes to their daily routines that can help them stay tobacco-free for life.

Authored by: Linda Bundick, MS, CHES, CHWC, NCTTP, Senior Coaching Lead at Pivot

Yellow swirl illustration
NRT can help support reduction and quit efforts

It's also a mainstay component of the Pivot program for those looking to quit smoking.

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