March 30, 2015
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Tobacco and Women: Trends and Strategies for Quitting
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Tobacco and Women: Trends and Strategies for Quitting

The Nicotine Gum — Nicorette® — OTC...For those who need oral stimulation
Nicorette® gum was the first type of NRT to be introduced. A nicotine compound is present in the surface of the gum. The nicotine is absorbed into the body through the membranes lining the mouth. It is poorly absorbed through the stomach. Therefore, it is very important to chew the gum correctly. The gum is initially chewed lightly until you sense a "peppery" taste. Then it is "parked" between the jaw below or above the teeth and the side of the cheek. Lightly chewing and parking are alternated for about 1/2 hour to get the full effect. There are currently two strengths of gum available- -2 mg and 4 mg. A heavy smoker (more than a pack per day) will find the 4 mg strength more helpful initially. Moderate smokers (1/2 - 1 pack per day) may do fine with 2 mg. The gum should be taken every 30 to 60 minutes at the beginning. Acid inactivates the nicotine compound, so rinsing the mouth with water after orange juice or coffee must be done before chewing a piece of gum. As mentioned before, chewing should not be vigorous, just intermittent, alternating with "parking" the gum. If chewing is vigorous, and the nicotine compound is swallowed, you may experience light-headedness, abdominal discomfort, hiccups and/or heartburn. These symptoms mean incorrect chewing technique. Read the directions and try again.

Chewing the gum at regular intervals results in a low steady level of nicotine in the blood. I find the gum particularly useful for people who are worried about weight gain because the gum occupies the mouth with a calorie-free substance. The gum is also useful for episodic smokers, who just need something to help them get over the urge.(5)

Nicotine Nasal Spray - Nicotrol NS® - OTC...For those with sudden urges
This type of NRT reaches the brain the fastest. It is particularly helpful for those who are having a lot of trouble with urges. The nicotine compound is transferred into the blood stream through the membranes of the nose and the back of the throat. The starting dose is a spray into each nostril once or twice every hour. The dose is not to be sniffed or breathed in. You will be very uncomfortable if you inhale the medicine into your sinuses. Clear out your nasal passages, hold the inhaler to your nostril, don't breathe, tilt back your head and simply spray. Nasal congestion from a cold or allergy will make this treatment less effective. The main side effect is nasal irritation, which tends to decrease with continued use.

The Nicotine Inhaler - Nicotrol® Inhaler - prescription...For those who miss handling cigarettes.
The nicotine compound is in a small capsule, which is punctured and placed in a plastic mouthpiece that resembles a cigarette holder. Inhaling through the holder brings the aerosolized nicotine in contact with the back of the throat, where it is absorbed into the bloodstream. The effect is about the same as the gum. The nicotine compound really does not go down into the lungs. This form of NRT is particularly useful for smokers who find the habit of handling the cigarette important. The side effects are similar to the nasal spray -- throat irritation that lessens with use.

Summary of NRT
Each form of NRT has certain characteristic that might be helpful to individual smokers:
  • the patch: automatic pilot
  • the gum: mouth is busy, no calories
  • the nasal spray: a quick hit for an urge
  • the inhaler: something to handle

Can these forms of NRT be used in combination? Yes. You could wear the patch and add any of the other three to help with your particular problem:
  • a piece of gum to keep from reaching for a piece of candy
  • a nasal spray to get over an urge
  • an inhaler to keep your hands busy

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