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Weaning with Nicotine replacement therapy(NRT)

Smoking has made the body used to the nicotine. If you want to stop smoking now, the body will want to compensate for the nicotine deficiency in a short time. Withdrawal symptoms can occur since no new nicotine is added. The aim of nicotine replacement preparations is now to give the body pure nicotine in order to alleviate withdrawal symptoms and to lower the nicotine level in the blood bit by bit over several weeks so that the products can be discontinued.

The main advantage is that the body only receives pure nicotine instead of other toxins (tar, carbon monoxide, etc.), as is the case with a cigarette. That alone is a health advance, even if it is far from being harmless to health.


Whether nicotine replacement products actually do what they promise is a very controversial issue. Many studies have tried to answer this question. In one study, for example, people took part who smoked at least 15 cigarettes, but mostly more than 20 cigarettes a day. All were offered nicotine replacement supplements to help them quit. After 6 to 12 months it was checked how many participants actually lived smoke-free.

The result is interesting: the study comes to the conclusion that nicotine replacement preparations can make it easier to quit. Without nicotine replacement therapy, 10 out of 100 people had become non-smokers.

With, it was 16 out of 100 people. So NRT helped 6 more people become non-smokers.

However, many researchers suspect that studies in which nicotine replacement products didn’t have a significant impact on success in quitting smoking wern’t published. There are estimates that nicotine replacement therapy can only help about 3 in 100 people.


The preparations do not usually require a prescription, but can only be bought in a pharmacy or at amazon. You must be at least 18 years old to receive nicotine replacement therapy. In addition, before starting such therapy, you should be examined by a doctor to determine whether such treatment is harmless to health.

In contrast to prescription drugs, nicotine replacement products usually do not cause serious side effects. These products aren’t subsidized by health insurance.

Note: Nicotine replacement products are medications. The package insert should therefore be read and a doctor should be consulted.

How to use the nicotine substitute

Before we look at the individual types of nicotine replacement product, it should first be clarified for whom such products are suitable, who may not use them and how long nicotine replacement therapy should last.

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Heavy smokers, i.e. people who

  • smoke at least 15 cigarettes a day
  • who need the first cigarette within 30 minutes of getting up
  • people who suffer from withdrawal symptoms when quitting

are recommended to resort to nicotine replacement therapy.

Which preparation is best for whom, unfortunately, cannot be said in general terms. I recommend that you read the manufacturer’s instructions. The following information does not claim to be complete and does not replace professional advice from a doctor. In particular, if you have already existing illnesses (e.g. cardiovascular problems), I urgently recommend that you seek advice from a doctor in advance when performing nicotine replacement therapy.

Nicotine Replacement Products: Who Is Not Suitable For Use?

Under no circumstances should people consider nicotine replacement therapy if the expected benefits of the therapy are disproportionate to the health risk. Specifically, this means that people with the following pre-existing conditions should NOT use nicotine replacement products:

  • Heart attack or unstable angina pectoris (Latin: tight chest)
  • Cardiac arrhythmia or ventricular arrhythmia (cardiac arrhythmia in the heart chambers)
  • Prinzmetal angina (spastic narrowing of the coronary arteries)
  • someone who has had a stroke

In addition, the following people should not come into contact with the nicotine preparation:

  • Nicotine Hypersensitive people
  • Pregnant women
  • Small children (mortal danger!)
  • Non-smokers or occasional smokers (less than one cigarette per day)

Nicotine replacement products in pregnancy

Smoking is particularly critical for pregnant women as it is harmful to the health of both the mother and the unborn child. Smoking during pregnancy increases the risk of a miscarriage significantly. It also increases the likelihood of a low birth weight and infant mortality. In addition, the nicotine passes into breast milk and is thus absorbed by the infant. It’s therefore strongly recommended to refrain from smoking during pregnancy and breastfeeding.

However, this should be done without the use of nicotine-containing preparations. It can also have negative consequences for the child. If it is too big a problem not to smoke during pregnancy, a doctor must be consulted urgently.

Quitting Smoking: How Long Does Nicotine Replacement Therapy Last?

The duration of therapy varies from manufacturer to manufacturer and from product to product. I therefore urgently recommend reading the package insert!

An average guide value is usually 12 weeks, in the rarest cases up to 20 weeks (5 months). We strongly advise against using the nicotine replacement product of your choice for longer than 24 weeks (6 months), as this could lead to new drug addiction.

Smoking cessation: the different nicotine replacement products

Basically, you can choose between nicotine patches, sprays, chewing gums, sucking tablets, inhalers and e-cigarettes. The latter, however, is not (yet) officially one of the types of nicotine replacement products.

The nicotine patch as a classic

The classic among nicotine replacement preparations is clearly the nicotine patch. It’s most commonly used by smokers to quit smoking. As with all other nicotine replacement products, the medicinal substance is natural, nicotine. The patches are available in different strengths to individually regulate the nicotine intake depending on the smoker and the time of withdrawal. The strength chosen depends on how many cigarettes the person has previously smoked. The patches are also available as 16-hour and 24-hour patches.

You shouldn’t use patches if you have skin conditions or allergies. You should definitely remove the plaster when bathing or showering!

Nicotine transdermal system patch 3 in one Pack

read more about ‘Nicotine Patches’

The nicotine gum as a substitute for smoking

Nicotine chewing gum comes in different flavors and strengths. The big advantage is that it works against the withdrawal and also keeps the hands and especially the mouth busy.

Nicotine gum is a medicinal drug. For this reason, the instructions and the instruction leaflet must be observed!

read more about ‘Nicotine chewing gum’

nicotine chewing gum, nicorette, 2 mg, friut chill flavoured, 160 pieces

NRT with lozenges

Although nicotine tablets are rather unknown, they are nonetheless a good way to start smoking cessation.

Note: Do not try to stop the therapy prematurely, as this will significantly reduce your chances of success.

read more about ‘Nicotine Lozenges’

Nicorette Lozenge  4 mg nicotine, stop smoking aid, mint flavoured, 24 pieces

The inhalator as a cigarette substitute

The nicotine inhaler is an active quitting aid to combat nicotine addiction. It consists of a mouthpiece and exchangeable nicotine cartridges. It’s intended to alleviate the desire to smoke and replace the cigarette.

read more about ‘Nicotine Inhalator’

nicorette inhaler with 15mg active ingredient

The nicotine spray as a very powerful option

The nicotine spray is one of the active quitting aids of the stronger kind, as it helps very quickly and immediately reduces withdrawal symptoms.

Even with the nicotine spray, you should definitely continue the treatment to the end, otherwise you would greatly reduce your chances of success.

read more about ‘Nicotine Spray’

Nicorette Spray in double pack.

Advantages and disadvantages of this therapy option


  • effectively combats addiction and withdrawal symptoms
  • Diseases caused by carbon monoxide, tar and other pollutants in cigarette smoke can be prevented
  • you avoid habitual cigarettes
  • Nicotine replacement products generally have few or trivial side effects compared to medicinal substitutes


  • Nicotine replacement products don’t make the decision to quit smoking for you
  • You still need to deal with changing your habits. Without this step, you will not be able to quit despite the nicotine substitutes
  • Nicotine replacement products are expensive and are not reimbursed by health insurance
  • When using the products, one must not forget that they are medicines and that there is a certain risk of becoming dependent on them.

Basically, NRT is very controversial. Unfortunately every smoker is different, which is why a complete guarantee to quit smoking can never be given. Nevertheless, I would like to introduce all the advantages and disadvantages of nicotine replacement therapy.

Warning: side effects and usage errors

The side effects of nicotine replacement products are similar to the side effects of smoking too much. Side effects occur when you consume too much nicotine. An overdose may occur. One speaks of nicotine poisoning, which has the following symptoms: headache, dizziness, nausea and a slight increase in blood pressure and heartbeat.

Side effects of nicotine patches, nasal sprays and lozenges

With nicotine patches in particular, skin irritation or itching can also occur at the relevant skin area. With nicotine nasal sprays, other side effects such as Irritation of the nasal mucosa as well as runny nose and sneezing known. Nicotine lozenges have sores in the mouth and throat as an additional side effect. In general, i can say that the side effects of special nicotine substitutes can occur especially in the first few weeks.

In addition, there are no serious side effects to fear with nicotine replacement products. If certain side effects become too unpleasant, it may be worth switching to another product or trying another manufacturer.

Nicotine substitutes: overdosing and incorrect use of the products

As already mentioned, an overdose leads to nicotine poisoning with the following symptoms: headache, dizziness, nausea and a slight increase in blood pressure and heart rate. Overdosing is much more likely in light smokers (fewer than 10 cigarettes a day) and non-smokers.

If an overdose is found, the nicotine replacement preparation must not be used. As soon as the nicotine level in the blood drops, the symptoms automatically decrease within a few minutes. If the nicotine poisoning is very serious, the necessary emergency measures must be taken immediately and a doctor must be consulted!

Smoking cessation: Combination of several substitutes

Especially with heavy smokers (more than 30 cigarettes per day) it can happen that a nicotine replacement preparation is not sufficient at least for the beginning. In these cases it’s advisable to combine several products. You can use nicotine patches for 8 or 12 weeks and, in addition, another quick-acting preparation (nicotine chewing gum, nicotine nasal spray or lozenge), which should be discontinued within the first 4 or 6 weeks.