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Nicotine replacement therapy: know the pros and cons of this smoking cessation treatment

Nicotine replacement therapy: know the pros and cons of this smoking cessation treatment

Nicotine replacement therapy (NRT) provides the patient with one of the most addictive substances in the cigarette without the risk of the other substances present in it are more harmful, such as tar and carbon monoxide. Thus, it helps reduce abstinence crises by withdrawing nicotine gradually and helping in the process of quitting.

Among the available methods for NRT, the nicotine patch has the highest adhesion, since it has fewer adverse effects and unpleasant. But there are also methods such as nicotine gum, nicotine gum, and nicotine nasal spray.

Electronic cigarette is not considered a method of nicotine replacement therapy, as its use does not always provide for gradual withdrawal of the substance , and contain amounts of the substance that are greater than that recommended for NRT.

For whom nicotine replacement therapy is indicated

In general Nicotine Replacement Therapy is used when the patient has high dependence, ie , if the patient has scored above five in a specific test, called the Fagerström Test, or when there is a history of withdrawal symptoms when the person is deprived of the smoke. In general, the use of this therapy in people who smoke less than 10 cigarettes per day is controversial, but needs to be considered on a case-by-case basis.

How Nicotine Replacement Therapy Works

The method consists in offering only nicotine in quantities much smaller than those offered in the cigarette, gradually reducing the amount given to the patient, and thus controlling his willingness to smoke while he reduces the number of cigarettes or ceases to consume them.

In the case of the adhesive, he is glued to the skin and gradually releases nicotine over 24 hours, after which it is changed. The chewing gum, the chewing gum and the spray are used on time, which allows an extra dose to be used during times of fissure. For this reason, the most common is to adopt the nicotine patch allied to the chewing gum or the tablet. But the most appropriate scheme should be guided by a physician who specializes in quitting smoking.

Expected results

A review reviewed in 2008 by the Cochrane Collaboration Database (a renowned worldwide association of health professionals and researchers) people who used the nicotine patch were able to become cigarette abstinent after six months, the chances were two to three times higher than those who used placebos. It was even better than placebo combined with behavioral support.

Advantages and disadvantages of nicotine replacement therapy

Any nicotine replacement therapy has the advantage of only replacing nicotine, sparing the hitherto smoker of being in contact with other harmful substances of the tobacco (like the tar, for example), but reducing the crises of abstinence, since the nicotine is reduced gradually.

The disadvantages depend on the side effect of each of the methods used within the nicotine replacement therapy.

Side effects

The side effects will vary according to the chosen method of replacement. To know more about each of them, see here:

Nicotine patch

Nicotine gum

Nicotine tablet

Nicotine nasal spray


For nicotine replacement only and in much smaller quantities than we found in cigarettes, there are no serious risks, since it is more responsible for smoking addiction than for the harm of smoking itself.

Precisely for this reason, there are not many contraindications for replacement therapies of nicotine, like the nicotine nasal spray, because continuing to smoke is always worse. Some experts claim that even people with heart disease and pregnant women can make use of these resources, because there is no evidence that this type of treatment causes problems for the health of the fetus.However, new studies have shown the relationship between nicotine and cancer. A study published in the scientific journal PLoS One in 2013 showed that the substance can alter the expression of the genes of the cells, making the appearance of the disease more likely. These findings may change the recommendation measures for this type of therapy.

Treatments Allied to Nicotine Replacement Therapy


In some cases, when the patient is heavily dependent on nicotine, the physician can ally the nicotine replacement therapies with drug treatment, using bupropion. The medicine also reduces the urge to smoke and can be taken for up to three months, but can only be bought with a prescription. Who May Indicate Nicotine Replacement Therapy

Nicotine patches, chewing gum and chewing gum may be purchased at the pharmacy without prescription. But ideally, any treatment involved in nicotine replacement therapy should be doctor-led so that it can combine other strategies and choose the best method for your case, according to your history and degree of addiction. Sources

Pulmonologist Luiz Carlos Côrrea da Silva (CRM-RS 4414), member of the Smoking Committee of the Brazilian Society of Pulmonology and Tisiology (SBPT) and the advisory council of the Smoking Control Alliance (ACTBr)

Psychologist Sabrina Presman, a specialist in smoking from the Brazilian Association of Alcohol and Other Drug Studies (ABEAD)

Book "Smoking: Disease that has treatment" (Editora ArtMed), organized by pulmonologist Luiz Carlos Côrrea da Silva

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