Statistics show an estimated 10,000 Malaysian’s die from smoke-related diseases or conditions on a yearly basis. Thirty percent of smokers above the age of 30 suffer from a whopping 40 kinds of illnesses that include heart related problems and 57 different types of cancer. Also, every day, approximately 50 teenagers below the age of 18 pick up the habit adding to the 100,000 youths worldwide; becoming hardcore smokers in the process. Circa 1998, the Government introduced therapy for smokers in four major hospitals around the country, namely in Kuala Lumpur, Penang, Ipoh and Seremban. KPJ Ampang Puteri has also joined this initiative by conducting a Nicotine Replacement Therapy (NRT) programme for those who wish to curb this addiction. In this article, Care For Life looks into this method as well as other forms of treatment.
What is Nicotine Replacement Therapy?
Nicotine replacement therapy (universally abbreviated to NRT) is the counteractive administration of nicotine to the body by method other that tobacco – and thus eschews the damaging effects of smoking. It involves the use of products that provide low doses of nicotine but do not include toxins that are found in smoke. The aim of this form of therapy is to mitigate craving for nicotine and ameliorate the symptoms an individual might face when he/she stops using cigarettes and smokes less tobacco. Generally, this form of therapy benefits moderate-to-heavy smokers (individuals who smoke more than 15 cigarettes a day) the most. Studies have shown that the occurrence of smoking after undergoing nicotine replacement therapy is 1.5-2.0 times less than when therapy is not introduced.
Types of Nicotine Replacement Therapy
• Nicotine patches (transdermal nicotine systems)
Nicotine patches provide a measured dose of nicotine via the skin. The patch is placed on a dry area of skin without much hair, below the neck and above the waist (upper arm or chest). In this form of NRT, the individual is deterred from nicotine by switching to patches that contain a lower dosage of nicotine over a period of several weeks. These patches are available without a prescription from your doctor. Depending on your body-size and smoking habits, most smokers should start by using a full-strength pack (15-22 mg of nicotine) on a daily basis for approximately 4 weeks. This should be continued by use of a weaker patch (5-14mg of nicotine) for another 4 weeks.
• Nicotine gum (nicotine polacrilex)
Available over the counter without a prescription, nicotine gum is a fast-acting method of replacement in which nicotine is taken in via the mucous membrane of the mouth. It is a preferred method of treatment, especially for those with sensitive skin, and are unable to make full use of a nicotine patch. Nicotine gum is highly recommended for smokers who smoke 25 or more cigarettes a day, feel the need to smoke within 30 minutes of waking up and have trouble refraining from smoking in restricted areas. One of the many advantages of using the nicotine gum is that it allows you to control the nicotine doses. Moreover, you can use it as and when you need to or on a fixed schedule during the day. Take note, that a fixed schedule has proved to be more effective, however, the as-needed approach will be favorable for when you need it most – when you experience cravings.
• Nicotine nasal spray
Another fast-acting method of treatment, the nasal spray treatment delivers nicotine to the bloodstream rapidly because it’s absorbed through the nose. This form of NRT however requires a doctor’s prescription. As per the other forms of treatment, the nasal spray lets you control your nicotine cravings and helps relieve withdrawal symptoms rather quickly. While smokers generally perfer the nicotine spray due to the ease of use, however, nicotine is addictive and thus, a smoker can transfer their dependence from cigaretter to the nasal spray. Hence, the need for prescription. Users are also strongly advised to use the nasal spray as per prescription only.
• Nicotine Inhalers
Nicotine inhalers, too, are only available by prescription from a doctor. Made up of a thin plastic tube with a nicotine cartridge inside, when you take a puff from the inhaler, the cartridge puts out a nicotine vapor. Unlike other inhalers such as the ones used by asthma patients, which delivers medicine to the lungs; this nicotine inhaler delivers most of the vapor to the mouth. This form of treatment is the most similar to actual smoking, which is widely appreciated by smokers in general. Thus far, this form of replacement therapy is the most expensive on the market. On another note, these inhalers should not be confused for electronic cigarettes, especially since those have not been clinically proven to be effective.
• Nicotine lozenges
Similar to the nicotine gum, nicotine-containing lozenges are available in 2 strengths: 2mg and 4mg, and can be purchase without a doctor’s prescription. Smokers are advised to choose their dose based on how long after waking up they usually have their first cigarette. It is recommended that smokers use these lozenges as part of a 12-week program.
Choosing the Right NRT
Although there is no actual evidence that one type of NRT is superior than the other, there are several factors that you should take into consideration when choosing which treatment you would like to embark on. When choosing your NRT look into your lifestyle and your smoking habits/patterns. For instance, do you only need to quench your nicotine craving or will you prefer something that will keep your hands and/or mouth busy?
Nicotine gums, lozenges and inhalers are substitutes you can put in your mouth that let you control your dosage and keep your cravings in check, however, nicotine gum may stick to dentures or other dental work, making it hard to chew. The gums and lozenges are also generally sugar-free. The nasal spray also works extremely quickly as and when you need it. On the other had, nicotine patches are more convenient as you only have to put it on once a day. However, if you are looking for more of a placebo effect, the inhaler allows you to simulate the use of cigarettes by holding and puffing the inhaler. Finally, studies have also shown that combing 2 types of NRT may work better than using just one single product. In that case, you may want to try using the patch for a steady dose of nicotine throughout the day and then using a fast-acting product i.e. nasal spray, inhaler, when the cravings become too overwhelming.
Other Methods
There are several other tools to aid in the process of quitting smoking that do not contain any forms of nicotine. Although some have acknowledged that these methods are useful, there is no strong proof that it improves the chances of quitting. These methods include hypnotherapy, acupuncture, and the use of smoking deterrents and/or herbal supplements. Although these methods have no scientific prove that it might work, certain individuals have found it useful. If you are interested in looking into these forms of treatment, discuss it with your doctor to see if it will be suitable for you.
Whichever method of treatment you choose to embark on, always remember to administer it at the recommended dosage only. There is a possibility, if you use a different dose or cease treatment prematurely that it will not work as expected. Whether you are a light smoker or a heavy smoker, it’s best to consult with your physician on a treatment plan that is tailored to suit your needs and match your lifestyle.
Written for AMG International, contract publishers of Care for Life
