Nicotine Replacement Therapy for Smoking Cessation
Yes, you can get a prescription for nicotine replacement therapy (NRT) products such as patches or lozenges to help you quit smoking, and combination NRT using both a patch plus a short-acting form like lozenges is the most effective approach for smoking cessation. 1
Benefits of Nicotine Replacement Therapy
- NRT approximately doubles your chances of successfully quitting smoking compared to trying without medication support 1
- NRT works by reducing withdrawal symptoms and cigarette cravings during the cessation process 2
- NRT provides nicotine in a way that is safer than cigarettes as it doesn't contain the tar and carbon monoxide found in tobacco smoke 1
- Blood nicotine levels from NRT are significantly lower than those from smoking cigarettes 1
Recommended NRT Approach
Combination NRT (Most Effective Option)
First-line recommendation: Use combination NRT that includes:
Combination NRT is nearly 3 times more effective than placebo (OR 2.73) 1
Combination NRT is 34% more effective than single NRT forms 1, 3
Dosing Guidelines
- Standard regimen: 21mg patch (worn continuously) plus short-acting NRT for breakthrough cravings 3
- Minimum treatment duration: 12 weeks 3
- May extend to 6-12 months for continued cessation support 3
- If the 21mg patch is not effective, consider increasing to 35 or 42mg 3
- For optimal results, use sufficient quantities for long enough duration 1
Behavioral Support Component
- Adding behavioral support to NRT significantly increases success rates - nearly 3-fold improvement 1
- Use NRT with a behavioral support program as directed on product labeling 2
- A minimum of 4 sessions of individual/group therapy in 12 weeks is preferred 3
Important Considerations
Safety Profile
- NRT is safe for most people; benefits outweigh potential risks 1
- Very few people become dependent on NRT 1
- Recent reviews suggest NRT is not linked to increased serious cardiovascular adverse events 1
- There is insufficient evidence that NRT increases cancer risk in humans 1
Common Pitfalls to Avoid
- Inadequate dosing (using too little NRT)
- Using only one form of NRT instead of combination therapy
- Stopping treatment too early (minimum 12 weeks needed)
- Not using behavioral support alongside medication
- Not preparing for withdrawal symptoms 3
Follow-up Recommendations
- Assessment within 2-3 weeks of starting therapy
- Continue follow-up at minimum 12-week intervals during therapy
- Additional follow-up at 6 and 12 months after successful quitting 3
Alternative Options
If NRT is not effective or appropriate, other FDA-approved options include:
- Varenicline (Chantix) - a non-nicotine medication that can be equally effective 1, 3
- Bupropion (Zyban) - can be used alone or with NRT 3
Speak with your healthcare provider about which option is best for you, particularly if you have any medical conditions or are taking other medications that might interact with smoking cessation products 4.