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Other Names:
Medicinal nicotine

This website fully supports the World Health Organization’s (WHO) Framework Convention on Tobacco (FCTC), in particular Article 1, which endorses “harm reduction strategies”.

Smokers can prevent tobacco-related disease. Quit or switch to smoke-free nicotine alternatives.

What Is It?

NRTs are products that provide nicotine, which is absorbed through the skin and mucous membranes – without the other harmful chemicals in tobacco. NRT products come in different formats, such as gum, patches, sprays, inhalers or lozenges. Patches, gum and lozenges can be purchased over the counter, while nasal sprays and inhalers require a prescription.

Medicinal nicotine products enable the user to absorb nicotine through the skin via transdermal patches or via the mucous membranes inside the mouth.

Why NRT Can Help You Quit Smoking

  • Nicotine in the form of NRT is on the World Health Organization’s List of Essential Medicines as the preferred method to quit smoking cigarettes.
  • Most medicine regulatory bodies have approved its use to reduce smoking-related death and disease.

Before you quit tobacco and want to try NRT, discuss your dose with a health professional.

NRT Products Work In Different Ways:

  • Nicotine gum is not meant to be used like regular gum, so follow the package instructions. Gum is usually recommended for six to 12 weeks. Gum releases fast-acting nicotine through the mucous membrane of the mouth.
  • The nasal spray inhaler comprises a thin plastic tube containing a nicotine cartridge that delivers a pure nicotine vapour into the mouth and throat when the user puffs on the inhaler. Inhalers deliver nicotine to the bloodstream more rapidly than other NRTs to relieve withdrawal symptoms and control nicotine symptoms. They should not be used for longer than six months.
  • Patches (transdermal nicotine systems) – provide a measured dose of nicotine through the skin to help the smoker wean off nicotine by switching to lower-dose patches over a course of weeks. Patches can be used for a total of three to five months.
  • Lozenges are available in various strengths (2 mg and 4 mg) and release nicotine through the mucous membranes of the mouth. The user sucks on the lozenge until it is fully dissolved (about 20 to 30 minutes). Nicotine lozenges should not be swallowed, bitten or chewed like a hard toffee.

Case Study

“A comprehensive Cochrane review, encompassing 136 trials with over 64,000 participants, demonstrated that all forms of nicotine replacement therapy (NRT)—including patches, gum, nasal sprays, inhalers, and lozenges—significantly increased the likelihood of quitting smoking. Specifically, NRT use resulted in a 50% to 60% higher success rate compared to placebo or no treatment. Importantly, these benefits were observed regardless of additional counseling or prescription status.

Additionally, a systematic review and meta-analysis published in the BMJ assessed the effectiveness and safety of NRT-assisted reduction to stop smoking. The study concluded that NRT is effective in aiding smoking cessation and is safe for use in individuals seeking to reduce or quit smoking.

These findings underscore the efficacy of NRT as a valuable tool for individuals aiming to quit smoking.”

Hartmann-Boyce, J., Chepkin, S. C., Ye, W., Bullen, C., & Lancaster, T. (2018). Nicotine replacement therapy versus control for smoking cessation. Cochrane Database of Systematic Reviews, (5), CD000146. Source Link
Moore, D., Aveyard, P., Connock, M., Wang, D., Fry-Smith, A., & Barton, P. (2009). Effectiveness and safety of nicotine replacement therapy assisted reduction to stop smoking: systematic review and meta-analysis. BMJ, 338, b1024. Source Link

Some nicotine-based alternatives include:

E-cigarettes

E-cigarettes (also called vaping) are battery-powered smoking devices, with cartridges containing nicotine and other ingredients that are heated into a vapour and inhaled.

Oral Nicotine Pouches

Oral nicotine pouches deliver nicotine through the lining of the mouth.

Heated Tobacco Products

Heated tobacco products heat tobacco, (but no burning of leaves) to producean inhalable vapour.

Nicotine Replacement Therapy

Nicotine Replacement Therapy (NRT) is used specifically for smoking cessation – in the form of nicotine gum, patches, sprays, inhalers or lozenges that are absorbed through the skin and mucous membranes.

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