Description

Pros

Cons

Nicotine Patch
(transdermal patch)

24 hour delivery systems
Available in 22, 21, 14, 11, or 7mg/24 hrs

16 hour delivery systems
Available in 14, 10, or 5 mg/16hr

• Easy to use
• Only needs to be applied once a day
• Few side effects
• Achieves high levels of nicotine replacement
• 16 hour patch is good for people who experience insomnia
• Over the counter

• Mild skin rashes and irritation due to adhesive
• Non-flexible dosing
• Slow onset of delivery

Nicotine Lozenge (Commit®)

Delivers nicotine through the lining of the mouth while the lozenge dissolves.

Available in 2 mg and 4 mg

• Easy to use
• Delivers approximately 25% higher dose of nicotine than nicotine gum
• Over the counter

• Should not eat or drink 15 minutes before or during use.
• Frequent nausea (12-15%)

Nicotine Polacrilex
(nicotine gum, Nicorette®)

Available in 2 mg or 4 mg

NOTE: This “gum” should be chewed briefly and then “parked” between the gum and cheek. Nicotine is absorbed through the lining of the mouth.

• Convenient
• Flexible dosing
• Faster delivery than patches
• Over the counter

• May be inappropriate for people with dental problems and those with TMJ syndrome
• Eating or drinking while using this “gum” is not recommended.
• Frequent use required to maintain adequate nicotine levels

Delivers nicotine through the lining of the nose when sprayed directly into each nostril.

• Flexible dosing
• Can be used in reponse to stress or an urge to smoke
• Fastest delivery of nicotine available
• Reduces cravings within minutes

• Nose and eye irritation is common, but usually disappears within one week
• Frequent use required to maintain adequate nicotine levels
• Prescription required

Nicotine Inhaler
(Nicotrol®Inhaler)

This is a plastice cylinder containing a cartridge that delivers the nicotine when puffed on.  The inhaler delivers the nicotine to the oral mucosa and enters the body much more slowly than the nicotine in cigarettes.

• Flexible dosing
• Mimics hand to mouth behavior of smoking
• Few side effects

• Frequent use required to maintain adequate nicotine levels
• May cause mouth and throat irritation
• Prescription required

Buproprion 

Nnon nicotine medicationZyban™  sustained release tablets

• Easy to Use
• Pill form
• Few side effects
• May be used in combination with NRT

• Should  not be used by patients with eating disorders, significant brain trauma, or if using MAO inhibitors
• Hypertension may occur, especially in combination with NRT
• Prescription required

Combination Nicotine Replacement Therapy

This would provide two types of delivery systems, one passive and one active.

• Permits sustained levels of nicotine with rapid adjustment for acute needs

• May increase risk of nicotine overdose
• Cost
• Prescription required