Products to Help you Quit: Nicotine Replacement Therapy

As you've probably figured out, there are a lot of stop smoking aids on the market that are supposed to help you quit smoking.  Some of the most common ones are what are called “Nicotine Replacement Therapy" products – like the patch, nicotine gum and lozenges, and nicotine sprays and inhalers. (The abbreviation “NRT" refers to this entire class of Nicotine Replacement Therapy products.) 

NRT products all work in about the same way and have similar success rates, so first I'll talk about them all together here.  At the bottom of this page I give you my recommendations, and  at the tabs above you'll also find more specific information about nicotine patches, nicotine gum and lozenges, and nicotine inhalers and sprays, if you’re interested in those specific stop smoking aids.

Stop Smoking Aids: How do they work? 

How do nicotine patches, nicotine gum, and other nicotine replacement products help you quit smoking?

The idea behind NRT is that quitting smoking will be easier if you don’t have to deal with nicotine withdrawal symptoms while you quit.  So NRT products work by replacing the nicotine you would have gotten from cigarettes after you quit smoking.  Since your body is still getting nicotine, you don’t suffer from nicotine withdrawal while you are using the NRT product.  For some people, this makes quitting smoking easier.

Of course, eventually you need to wean yourself off of the nicotine from the NRT product, too, or you have just replaced one type of addiction with another one…  Fortunately, most of these stop smoking aids come with instructions for tapering off the product after you've quit smoking.  Tapering helps to minimize nicotine withdrawal symptoms you might experience when you get off the NRT product. 

Here’s an important fact about NRT products:  According to the FDA, smoking while on NRT can be dangerous, so you really do have to quit before you start to use one of these.

Success Rates: Do NRT products really work?

Is there any evidence that nicotine patches, nicotine gum, and other NRT stop smoking aids actually help people quit successfully?

The answer to this is yes, there is research that shows that NRT stop smoking aids do help people quit, but the effect is relatively modest.  Meta-analytic research shows that NRT products increase your chances of quitting successfully by a factor of about 1.75.  In other words, people using some form of NRT were almost twice as likely to quit successfully as people who were not using NRT.  There was no difference in the success rates for different NRT products.

To keep this in perspective, though, the success rate for people quitting cold turkey is about 5%, so a product that doubles success rates would give you about a 10% chance of quitting successfully, on average, if used by itself.  (Keep in mind that most stop smoking aids can and should be used with a behavioral plan for quitting to improve your chances of success.)

Since all forms of NRT work basically the same way – that is, they all deliver replacement nicotine – it makes sense that the success rates are about the same.  So if you decide to try NRT, since there is no overall difference in success rates you can simply choose the one that fits your preferences.  Be sure to read the pros and cons below, and the pages about each type of NRT to find out about differences in levels of addictiveness and side effects you can expect, if you decide NRT is something you want to try. 

I also make some specific recommendations at the end of this page about nicotine replacement products generally, and about quitting smoking.

Pros and Cons

What are the pros and cons of NRT products overall?

Pros:

  • The main ‘pro’ about NRT stop smoking aids is that they do help you deal with the physical addiction to nicotine when you quit smoking.  They do this by replacing the nicotine from cigarettes with the nicotine from the product, so that you don’t suffer from nicotine withdrawal while you are quitting.  (You may suffer some physical withdrawal later, when you have to wean yourself from the product, but it should be fairly minimal because of the tapering process.)

Cons:

  • The primary downside is that NRTs by themselves do not help you deal with the psychological dependence, but if you choose to use them, they can – and should – be combined with a program or plan to help deal with psychological issues related to quitting smoking. 

  • NRTs are physically addictive – just like cigarettes – because they contain nicotine, and will require you to ‘quit’ them, as well.  (See the pages on the different types of products to read more about which ones are most addictive and difficult to quit.)

  • NRTs may have side effects, such as skin irritations, sleep disturbances, sore throat, etc., depending on which one you choose.  (You can read more about the specific side effects on the pages for each product type.)

  • NRTs can be relatively expensive, ranging from about $250 for a full course of treatment with patches or gum to nearly $2,000 for a course of inhaler treatment.

  • Some NRT products require a prescription from your doctor, making them less convenient.

How to Choose

How do you decide if an NRT approach is right for you, and if so, which stop smoking product should you choose? 

Since NRT helps only with the physical addiction, if you choose this option, it will be really important to combine it with a behavioral program to help you deal with the psychological aspects of smoking. 

The table below compares each of the NRT products to help you decide whether an NRT product may be the best quit smoking aid for you.  For comparison, I've include a simple alternative that works on the same principle as NRTs – the gradual reduction of nicotine.  This technique is called nicotine fading, which is sometimes used in structured programs for quitting.

Compare Stop Smoking Aids

 

Prescription Needed?

Treatment

Length

Addictive?

Side Effects?

Estimated Cost

Patch

No

8-10 weeks

Yes

Yes

~$225+

Gum

No

12 weeks

Yes

Yes

~$300

Lozenges

No

12 weeks

Yes

Yes

~$300

Nasal Spray

Yes

12-14 weeks

Highly

Yes

~$350+

Inhaler

Yes

3-6 months

Highly

Yes

~$1800+

Alternative technique:

 

 

 

 

Nicotine Fading

No

2 – 4 weeks

No

No

None

 

My Recommendations

The most important thing I can say about NRT stop smoking aids is that they are not a ‘magic pill’ that will make quitting effortless.  They are one way to help avoid the physical withdrawal from nicotine while you quit, but for most people, the psychological dependence is at least as important as the physical addiction, when it comes to trying to quit.  So my advice is to come up with a plan for dealing with the psychological aspects of your dependence, and then see if NRT works well within that plan. 

All of the FDA-approved NRT products pretty much do what they are designed to do, which is replace nicotine after you quit so you can temporarily avoid withdrawal symptoms.  However, they differ in areas such as cost, ease of use, and their level of addictiveness. 

If you think NRT may be right for you, use the links on this page to find out more about the different types of NRT stop smoking aids, including common side effects, contraindications for use and the potential for ongoing addiction.