Nicotine Replacement Therapy
Nicotine replacement therapy delivers nicotine, which is safe and non-toxic. There are three predominant mechanisms by which NRT works i.e. It reduces withdrawal symptoms, partially reduces the reinforcing effects of tobacco-delivered nicotine and may provide some effects for which the patient previously relied on tobacco, such as sustaining desirable mood and attention states, making it easier to handle stressful or boring situations, and managing hunger and body weight. NRT comes in five forms i.e. gum, pastille/lozenge, patch, inhaler and spray.
NRT significantly increases the likelihood of tobacco abstinence by 1.5 times compared with a placebo. The odds of long term smoking abstinence with different forms of NRT varies from 1.43 for gum to 2.02 for nasal spray. NRT when used in the proper dose and duration, increases the long-term abstinence by 50-70% irrespective of treatment setting or type of counselling or type of behavior therapy.
The dose of NRT depends on the severity of tobacco use. A better outcome is associated with adequate dose and duration. NRT is recommended for a minimum period of 12 weeks. NRT can be initiated even in a person who has not decided to quit tobacco. NRT is recommended for 12 weeks, but the increased duration of use has a better outcome.
NRT (Gum, Patch, Pastilles(Lozenge), Spray, Inhaler) is a safe and effective treatment for dependence on both forms of tobacco. The first three are available in India.
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