From the Guidelines
Nicotine gum and inhalers are both effective for smoking cessation, but combination NRT, such as nicotine patch plus short-acting NRT like gum or inhaler, is the preferred primary therapy. When choosing between nicotine gum and inhaler, consider the individual's needs and preferences. Nicotine gum provides flexible dosing (2mg or 4mg) and discreet use, suitable for those who need oral stimulation or gradual nicotine delivery 1. On the other hand, nicotine inhalers mimic the hand-to-mouth action of smoking, delivering nicotine through a cartridge inserted into a plastic mouthpiece, and may be more suitable for those who miss the physical ritual of smoking 1.
Key points to consider when using nicotine gum or inhalers include:
- Using them according to a tapering schedule over 8-12 weeks, gradually reducing usage as withdrawal symptoms decrease
- Combining them with other cessation methods, such as behavioral therapy, for better success rates 1
- Being aware of potential side effects, such as jaw soreness and hiccups with gum, and throat irritation with inhalers
- Considering combination NRT, such as nicotine patch plus short-acting NRT, as the preferred primary therapy for smoking cessation 1
It's essential to note that combining pharmacologic therapy and behavior therapy is the most effective approach for smoking cessation, and high-intensity behavior therapy with multiple counseling sessions is most effective 1. Ultimately, the choice between nicotine gum and inhaler should be based on individual preferences and needs, and both options can be effective when used as part of a comprehensive smoking cessation plan.
From the Research
Nicotine Gum versus Inhaler for Smoking Cessation
- The provided studies do not directly compare nicotine gum to an inhaler for smoking cessation, but they do discuss the effectiveness of nicotine gum and other nicotine replacement therapies (NRT) in quitting smoking 2, 3, 4, 5.
- A study on quitting by gradual smoking reduction using nicotine gum found that smokers on active gum were significantly more likely to achieve initial cessation, 28-day continuous abstinence, and continuous abstinence at 6 months compared to those on placebo 3.
- Another study found that nicotine gum did not significantly improve outcomes for non-daily smokers, including those with some degree of dependence, although gum use was low in this study 4.
- A review of different doses, durations, and modes of delivery of NRT found that combination NRT (fast-acting form + patch) results in higher long-term quit rates than single-form NRT, and that 4 mg gum is more effective than 2 mg gum, especially for highly dependent smokers 5.
- There is no direct evidence in the provided studies to compare the effectiveness of nicotine gum to an inhaler for smoking cessation, as the studies focus on gum, patches, and other forms of NRT 2, 6, 3, 4, 5.
Effectiveness of Nicotine Replacement Therapy
- The studies suggest that NRT, including nicotine gum, can be an effective aid in quitting smoking, especially when used in combination with other forms of NRT or with behavioral counseling 2, 3, 5.
- The evidence supports the use of combination NRT, such as a fast-acting form (like gum) and a patch, for higher long-term quit rates 5.
- The effectiveness of NRT can depend on factors such as the dose and duration of treatment, as well as individual characteristics like nicotine dependence 3, 4, 5.
Safety and Tolerability of Nicotine Replacement Therapy
- The studies found that NRT is generally safe and well-tolerated, although there can be side effects like nausea, insomnia, and anxiety 2, 6, 5.
- The evidence on the safety and tolerability of different types of NRT is of low or very low certainty, and more research is needed to fully understand the risks and benefits of NRT 5.