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Understanding nicotine addiction and how to quit

Nicotine addiction can be so tough to beat, but have you considered how Niquitin's NRT can play a vital role in helping smokers quit?

Nicotine addiction

Almost 1 in 6 adults smoke1, despite knowing it is harmful. To help people quit smoking, we need to understand their addiction and why it is so hard to give up.

A burning cigarette releases more than 7000 chemicals, of which at least 69 can cause cancer and other smoking-related harm2. Nicotine itself does not cause cancer, but keeps people hooked on tobacco4.

When you inhale nicotine, it is rapidly absorbed into the bloodstream, reaching the brain in about 6-10 seconds4. This rush produces the feelings of pleasure.

Why is nicotine so addictive? Nicotine alters the balance of the feel-good chemical dopamine in the brain, giving you that “hit” or “buzz”, producing feelings of pleasure, whilst reducing short-term stress and anxiety3. Repeated exposure increases the number of nicotine receptors in the brain, creating a demand for more, fuelling the compulsion to smoke3. Long-term smoking permanently alters the brain circuits involved in learning, stress and self-control3.

Over time, smokers build up a tolerance, such that they need more nicotine to get the same pleasurable effect5. Smoking becomes associated with certain activities and situations that trigger the craving for a cigarette. Before you realise it, you have become physiologically dependent on nicotine. 

Nicotine deprivation brings with it unpleasant withdrawal symptoms, such as irritability, anxiety and low mood, as well as sleep disturbances and increased appetite5. Avoidance of these side effects , alongside the craving for nicotine, often drives the quitter back to cigarettes.

Nicotine Replacement Therapy 

Nicotine cravings can be the hardest thing to handle when trying to quit6. Nicotine replacement therapy, or NRT, temporarily substitutes the nicotine from cigarettes, reducing the urge to smoke and lessening the impact of withdrawal symptoms7.

NRT activates the dopamine reward pathway with a lower dose of nicotine and at a much slower rate than the rush that comes from a cigarette8.  NRT does not replace the experience of smoking; instead it reduces withdrawal symptoms and lessens the cravings that get in the way of quitting for good9. It can take at least 6 weeks for the brain to adjust to the absence of nicotine9.

The big question is can NRT really help people quit smoking? The answer is an emphatic yes!

Numerous studies have proven that smokers who are motivated to quit will find NRT to be more effective than abstinence alone9. Evidence also shows that NRT can help to reduce cigarette consumption before the planned quit date2.

NRT is a well-tolerated treatment strategy9. Just as with their smoking habit, the right NRT choice for each quitter will depend on their personal preference, convenience, tolerability and costs9. Each NRT option can be used alone or in combination, but it is important they are used correctly.

Different NRT products can help with different aspects of nicotine withdrawal. There can be a need for 24-hour resistance to regular cravings and also those intense cravings that break through at trigger moments. Transdermal patches aim to deliver nicotine at a rate that helps with all-day craving control10, whereas nicotine lozenges or gums can work to relieve cravings that strike during social activities or when stressed9. These can be used in combination to help make it through the day without a cigarette8,9

NRT is a well-established therapy, but myths and misconceptions still abound – such as that NRT products perpetuate the addiction to nicotine. This is simply not true. The nicotine in patches, gums and lozenges is not the same as smoking11, and has a very low risk of harm – it is the combination of tar and cancer-causing chemicals in cigarettes that do the damage11.

NiQuitin

NRT products come in different dose strengths and deliver nicotine at different rates, and can be used in combination to manage cravings of different intensity, at different times of day or night.

NiQuitin patches use smart control technology for rapid release of therapeutic nicotine,  as well as a continuous flow of nicotine for 24-hours.  NiQuitin patches come in 7, 14 and 21 mg strengths that allow daily dose management for smokers with different needs for symptom control.

NiQuitin patches are clinically proven to double the chances of stopping smoking compared to willpower alone12. Heavier smokers can start with 21mg patches, progressively stepping down to the 14mg and 7mg patches. Smokers quitting a less-than-10-a-day habit can start with the 14mg patch before stepping down to the 7mg dose.

NiQuitin mini lozenges start to relieve cravings in just 3 minutes when the need to smoke seems irresistible. The dispenser is even shaped like a cigarette lighter to fit with the physical habits associated with smoking.

Using nicotine patches and lozenges in combination is clinically proven to be more effective than using either one alone13.

By using NiQuitin patches and NiQuitin lozenges, each smoker can find the right dose and the appropriate combination of products to help them successfully quit smoking for good.

References

  1. Office of National Statistics: Adult smoking habits in the UK: 2017 https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthandlifeexpectancies/bulletins/adultsmokinghabitsingreatbritain/2017;
  2. U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General, 2014.
  3. Picciotto MR, Mineur YS. Molecules and circuits involved in nicotine addiction: The many faces of smoking. 
  4. Benowitz NL,  Hukkanen J and Jacob P. Nicotine Chemistry, Metabolism, Kinetics and Biomarkers.
  5. Benowitz NL. Nicotine Addiction.
  6. NHS Smokefree UK. Expert Support: NHS Stop Smoking Medicines. Available at: https://www.nhs.uk/smokefree/help-and-advice/prescription-medicines
  7. Stead LF et al. Nicotine replacement therapy for smoking cessation.
  8. Benowitz NL. Pharmacology of nicotine: Addiction, smoking-induced disease, and therapeutics.
  9. Shiffman S, Ferguson SG. The effect of a nicotine patch on cigarette craving over the course of the day: results from two randomized clinical trials.
  10. Fant RV et al. A pharmacokinetic crossover study to compare the absorption characteristics of three transdermal nicotine patches.
  11. Luty J. 2002. Nicotine addiction and smoking cessation treatments.
  12. ShiffmanS et al. Comparative efficacy of 24-hour and 16-hour transdermal nicotine patches for relief of morning craving.
  13. Shiffman 2002. Efficacy of a nicotine lozenge for smoking cessation.
 

Product information 

NiQuitin Clear 21, 14, 7 mg patches: Contains nicotine. Stop Smoking Aid. Requires willpower. Always read the leaflet. Legal classification: GSL. PL 02855-0237 (7mg), PL 02855-0251 (14mg), PL 02855-0253 (21mg). MAH: Omega Pharma Ltd, 32 Vauxhall Bridge Rd, London SW1V 2SA. RRP (ex. VAT): £13.00

Information about the product including adverse reaction, precaution, contra-indication and method of use can be found at: https://www.medicines.org.uk/emc/product/2938/smpc (21mg), http://www.medicines.org.uk/emc/medicine/15343  (14 mg), http://www.medicines.org.uk/emc/medicine/15342  (7mg)

NiQuitin Minis Mint 1.5 mg/4mg Lozenges. Contains nicotine. Stop Smoking Aid. Requires willpower. Always read the leaflet. Legal classification: GSL.  PL 02855/0248 (1.5mg) PL 02855/0249 (4mg) MAH: Omega Pharma Ltd, 32 Vauxhall Bridge Rd, London SW1V 2SA. RRP (ex. VAT) single pack: £5.50; Triple Pack £15; Information about the product including adverse reaction, precaution, contra-indication and method of use can be found at: http://www. medicines.org.uk/emc/medicine/22194 (1.5mg), http://www.medicines.org.uk/emc/medicine/22195 (4mg) Date of preparation: 09/2018.

NiQuitin Extra Fresh Mint 2 mg/4 mg Medicated Chewing Gum. Contains nicotine. Stop Smoking Aid. Requires willpower. Always read the leaflet. Legal classification: GSL. PL 02855/0265 (2mg), PL 02855/0266 (4mg). MAH: Omega Pharma Ltd, 32 Vauxhall Bridge Rd, London SW1V 2SA. RRP (ex. VAT):  £16.00.

Information about the product including adverse reaction, precaution, contra-indication and method of use can be found at: https://www.medicines.org.uk/emc/product/2718/smpc (2mg), https://www.medicines.org.uk/emc/product/2717/smpc (4mg) Date of preparation: 09/2018.

NiQuitin Mint 2mg/4mg Lozenges. Contains nicotine. Stop Smoking Aid. Requires willpower. Always read the leaflet. Legal classification: GSL. PL

12063/0113 (2mg), PL 12063/0114 (4mg) MAH: Wrafton Laboratories Limited, Trading as Perrigo, Wrafton, Braunton, Devon, EX33 2DL, UK. RRP (ex. VAT) £10.00

Information about the product including adverse reaction, precaution, contra-indication and method of use can be found at: https://www.medicines.org.uk/emc/medicine/32959 (2mg), https://www.medicines.org.uk/emc/medicine/32958 (4mg) Date of preparation: 09/2018.

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