How to quit

Some people find nicotine cravings the hardest thing to handle about quitting.

If that sounds like you, then no need to worry. There are plenty of Nicotine Replacement Therapy (NRT) products out there and they can give you the extra support you need to beat the addiction. In fact, like the other licensed stop smoking medicines, used in combination with your local Stop Smoking Service you’re four times more likely to stay quit!

How they work
Cigarettes contain nicotine. By smoking regularly and over a long period of time, your body becomes dependent on nicotine. Giving up smoking can cause nicotine withdrawal symptoms, which include cravings, headaches, feeling irritable and not being able to sleep. Stop smoking medicines can help you manage these withdrawal symptoms.

There are three types of stop smoking medicines:

  • Champix tablets (Varenicline)
  • Zyban tablets (Bupropion)
  • Nicotine Replacement Therapy (NRT) including patches, gum, lozenges, microtabs, inhalator and nasal sprays

All of them are available from the service, and Nicotine Replacement Therapy can also be bought from pharmacies without a prescription and other shops (such as supermarkets).
All are effective treatments to help you stop smoking, but you may find one suits you more than another. There are lots of things to take into account, so we recommend that you speak to your local Stop Smoking Practitioner, your doctor or pharmacist for further advice.

Is taking nicotine replacement therapy safe?
NRT is suitable for most adults, but if you have a heart or circulatory condition, or are on regular medication, you should check with your doctor. Similarly, if you are pregnant you should ask your M2B Practitioner, doctor or midwife before using NRT.

 

Gum
Gum is available in two strengths: 2mg and 4mg. The 4mg gum is most appropriate for smokers who smoke more than 20 cigarettes a day, or who are strongly addicted to nicotine.

When you use nicotine gum, the nicotine is absorbed through the lining of your mouth. When you first quit you should be chewing about 1 piece of gum every hour. To release the nicotine from the gum, chew until the taste becomes strong or hot. After this you can rest the gum inside your cheek. Once the taste or heat fades you will need to chew again to release more nicotine. Discard the gum after about an hour.

Gradually you can begin to cut down on the amount of gum you use. Try chewing for shorter periods, using smaller pieces, a lower dose or alternating with a non-nicotine gum.

Is gum right for me?
Gum can be helpful because it provides short bursts of nicotine. However, some people can find the taste unpleasant or dislike having to ‘park’ the gum in their mouth.

 

Nicotine patches
Nicotine patches work well for most regular smokers and can be worn round the clock (24 hour patches) or just during the time you are awake (16 hour patches), and they work by releasing nicotine directly into the bloodstream through the skin.

How to use patches
There are two ways to use patches: just during the time you are awake (16 hour patch) or both day and night (24 hour patch). The 24 hour patch may cause some sleep disturbance but is helpful for people who have strong cravings during the early morning.

Patches also come in different strengths. Whichever strength you start on you should aim to gradually reduce the strength over time before stopping the usage of patches completely.

Who should use patches
Patches are useful for those who are concerned about discretion (they can be worn easily beneath clothing) or dislike the taste of the oral products. They release a steady amount of nicotine. They may also cause skin irritation for some people.

However patches may cause skin irritation for some people.

 

Microtab
These are small tablets containing nicotine which dissolve quickly under your tongue

How to use microtabs
Microtabs are designed to be dissolved under the tongue. Make sure you don’t chew or swallow them – this may cause unwanted side effects.

When you quit you should use one or two tablets every hour for up to three months after you quit. You should then be able to gradually cut back your consumption. Once you are taking one or two tablets a day you should be able to stop completely.

Who should use microtabs
Microtabs can also be used by those who are trying to reduce the number of cigarettes they smoke, as well as those who have quit completely. You should stop smoking within 6 months of using microtabs.

Side effects of microtab
Possible side effects include: hiccups, sore throat, burning sensation in mouth

 

Lozenges
Lozenges are placed in the mouth and dissolve slowly to release the nicotine and take about 20-30 minutes to dissolve.

How to use lozenges
Nicotine lozenges work in a similar way to nicotine gum. To release the nicotine from the lozenge, suck until the taste becomes strong or hot. After this you can rest the lozenge inside your cheek – once the taste fades you will need to suck again to release more nicotine. Suck until the lozenge has completely dissolved – each one should last 20 to 30 minutes.

You should use lozenges for about twelve weeks. For the first six weeks you should have one lozenge every one to two hours. You should then reduce your intake to one lozenge every two to four hours, finally reducing to once every four to eight hours in the last two weeks of treatment.

Who should use lozenges
Lozenges are helpful because they provide short bursts of nicotine. Lozenges should not be used by people with mouth ulcers.

 

Inhalators
Inhalators look like a plastic cigarette. The inhalator releases nicotine vapour which gets absorbed through your mouth and throat. If you miss the ‘hand to mouth’ aspect of smoking, these may suit you.

How to use inhalators
A nicotine inhalator works by releasing nicotine vapour when you suck on it. Inhalers work very quickly so you should reach for your inhaler whenever you feel strong cravings for a cigarette. Each inhalator contains a disposable cartridge which has enough nicotine for around 3 to 4, 20 minute puffing sessions. This equates to around 400 puffs.

You should use the inhalator for a total of twelve weeks. Use between six and twelve cartridges per day for the first eight weeks depending on how many cigarettes you smoke. For the following two weeks reduce this by half, finally stopping the use of the inhalator completely in the last two weeks of treatment.

Who should use inhalators
The advantages of inhalators are that they work much more quickly than gum or lozenges. They can be therefore used directly when you experience cravings for a cigarette. They also feel very similar (because of the motion involved in using them) to a cigarette so become a good replacement – especially for those who miss the ‘hand to mouth’ aspect of smoking.

 

Nicotine nasal spray
The spray delivers a swift and effective dose of nicotine through the lining of your nose.

How to use nasal spray
You use the nasal spray by releasing one spray into each nostril twice an hour. It should be used no more than five times an hour and no more than forty doses a day. Each dose will give the equivalent nicotine contained in one cigarette. This is the fastest way that nicotine can enter the bloodstream reaching the brain within 10 minutes.

You should use the nasal spray for a total of twelve weeks. Use between one and two doses per hour for the first eight weeks depending on how many cigarettes you smoke. For the following two weeks reduce this by half, finally stopping the use of the nasal spray completely in the last two weeks of treatment.

Who should use nasal spray
The advantages of nasal sprays are that they work much more quickly than gum or lozenges. They can therefore be used directly when you experience cravings for a cigarette – and most closely mimic the rush you get from smoking than any of the other forms of NRT.

The nicotine nasal spray is the strongest form of nicotine replacement therapy. This can be a very useful and effective form of medication for highly dependent heavy smokers who have difficulty giving up using other methods.

However this method is not suitable for everyone and may cause side-effects such as nose and throat irritation, coughing, and watering eyes.

 

Champix (Varenicline)
Only available to people aged 18 or over. Prescription only medication

Champix works by reducing your craving for a cigarette and by reducing the effects you feel if you do have a cigarette. You set a date to stop smoking, and start taking tablets 1 or 2 weeks before this date. Treatment normally lasts for 12 weeks. Champix is only available on prescription and is not available if you are pregnant or if you have some pre- existing conditions – discuss with your Doctor or health care professional.

For more information please read the Patient Information Leaflet.

 

E-cigarettes
Public Health England reports that e-cigarette use is around 95% less harmful to health than smoking. The report encourages smokers who want to use e-cigarettes as an aid to quit smoking to seek the support of their local stop smoking service. SmokeFreeLife Somerset has experienced staff who can provide support, and advice through the quitting process. Quitting can be difficult at times, and we are here to make this journey as smooth as possible.

Find out more about e-cigarettes

 

Zyban Buproprion Hydrochloride
Only available to people aged 18 or over. Prescription only medication

Zyban is a tablet which helps you to stop smoking. You start taking Zyban one to two weeks before you quit and treatment usually lasts for a couple of months to help you through the withdrawal cravings. It’s only available on prescription and is not available if you are pregnant, or if you have some pre-existing conditions – discuss this treatment option with your practitioner and/or your GP.

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