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Nicotine replacement therapies aid smoking cessation.

Nicotine replacement therapy (NRT) is available in a range of product formulations including nicotine gum, inhalator, lozenge, sublingual tablet, nasal spray and patch (six products). It is a well established treatment for smokers attempting to quit, with more than 90 trials comparing different forms of NRT with non-NRT controls. Trials have generally recruited smokers of >10 cigarettes per day and included some behavioural support.

Not all NRT types are available in all countries. Fewer trials of the sublingual tablets and lozenges and of over-the-counter NRT have been published, but their results are consistent with trials of other products and in other settings. Combining NRTs appears to increase quitting.

Starting to use NRT before a planned quit date might assist cessation. Meta-analysis suggests a small benefit although more recent larger studies have shown less evidence of benefit than the initial trials.

Continued use of NRT for longer than the standard duration of treatment course is safe and may reduce relapse whilst used but it is unclear whether a benefit persists once medication use stops.

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Stead LF, Perera R, Bullen C, Mant D, Hartmann-Boyce J, Cahill K, Lancaster T. Nicotine replacement therapy for smoking cessation. Cochrane Database of Systematic Reviews 2012, Issue 11. Art. No.: CD000146. DOI: 10.1002/14651858.CD000146.pub4.

Report of the Committee on Safety of Medicines Working Group on Nicotine Replacement Therapy . Medicine and Healthcare products Regulatory Agency Committee on Safety of Medicines, 2005.

Bullen C, Howe C, Lin RB, Grigg M, Laugesen M, McRobbie H et al. Pre-cessation nicotine replacement therapy: Pragmatic randomized trial. Addiction. 2010; 105 (8):1474-1483.

Shiffman S, Ferguson SG. Nicotine patch therapy prior to quitting smoking: A meta-analysis. Addiction. 2008; 103 (4):557-563. logo
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