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Nicotine replacement therapy (NRT) has significantly evolved since the Nicorette gum’s inception in 1984. In a 2023 study featured here, 43.4% of regular cigarette smokers were motivated to try smokeless options like LUCY Chew and Park, introduced in 2022, to quit smoking. Even smokers without plans to quit had 9.8 times higher odds of expressing an intention to try the gum compared to former smokers. This suggests that consumer nicotine gum may reduce harm by substituting for higher-risk products like combustible cigarettes, highlighting the growing demand for alternatives to traditional smoking.
The three-decade gap between LUCY and Nicorette underscores the continuous development of nicotine gum as one of the most popular methods for smoking cessation. Yet, the gum is only one out of the many NRT options available in the market today. Below, we take a closer look at its evolution and the role it plays in smoking cessation.
The science behind smoking addiction:
At its core, NRT acknowledges the physical and psychological complexities of nicotine addiction. Nicotine, the addictive substance in tobacco, activates specific receptors in our peripheral and central nervous systems known as “nicotinic acetylcholine receptors.” According to this article, nicotine binds to these receptors when individuals inhale cigarette smoke, triggering a release of neurotransmitters, including acetylcholine and norepinephrine. This interaction results in a simultaneous surge of cortisol, the stress hormone, and dopamine, the pleasure hormone. The initial pleasure associated with smoking contributes to the addictive nature of nicotine.
However, prolonged smoking can lead to desensitization in neurotransmitter levels, affecting mood regulation and the stress response. The brain’s dopamine, serotonin, and glutamate levels are altered, creating imbalances that impact mental health. The temporary relief provided by smoking turns into a vicious cycle as the brain associates the drop in dopamine levels with heightened anxiety and stress, especially as the elevated amounts of cortisol linger in the body. Users then turn to back to smoking to alleviate these feelings, reinforcing their dependence on nicotine.
However, prolonged smoking can lead to desensitization in neurotransmitter levels, affecting mood regulation and the stress response. The brain’s dopamine, serotonin, and glutamate levels are altered, creating imbalances that impact mental health. The temporary relief provided by smoking turns into a vicious cycle as the brain associates the drop in dopamine levels with heightened anxiety and stress, especially as the elevated amounts of cortisol linger in the body. Users then turn to back to smoking to alleviate these feelings, reinforcing their dependence on nicotine.
The role of NRT
Understanding this intricate connection between nicotine and neurotransmitters emphasizes the importance of NRT in smoking cessation. Its fundamental principle involves the controlled administration of nicotine through various forms, with the ultimate goal of facilitating a gradual reduction in nicotine intake. This firstly addresses the physical aspect of addiction, mitigating withdrawal symptoms and the intense cravings associated with quitting smoking. Secondly, NRT serves as a practical substitute for the habitual and sensory aspects of smoking, offering users a tangible alternative to the act of smoking itself. By providing a measured approach to nicotine reduction, NRT acts as a bridge, helping individuals transition from active smoking to complete abstinence.
This comprehensive strategy recognizes that successful smoking cessation is not just about breaking a physical addiction but involves addressing the intricate behavioral and psychological components ingrained in the habit of smoking. NRTs are thus best used in tandem with counseling or other behavioral interventions.
Understanding this intricate connection between nicotine and neurotransmitters emphasizes the importance of NRT in smoking cessation. Its fundamental principle involves the controlled administration of nicotine through various forms, with the ultimate goal of facilitating a gradual reduction in nicotine intake. This firstly addresses the physical aspect of addiction, mitigating withdrawal symptoms and the intense cravings associated with quitting smoking. Secondly, NRT serves as a practical substitute for the habitual and sensory aspects of smoking, offering users a tangible alternative to the act of smoking itself. By providing a measured approach to nicotine reduction, NRT acts as a bridge, helping individuals transition from active smoking to complete abstinence.
This comprehensive strategy recognizes that successful smoking cessation is not just about breaking a physical addiction but involves addressing the intricate behavioral and psychological components ingrained in the habit of smoking. NRTs are thus best used in tandem with counseling or other behavioral interventions.
Types of NRT
Over the years, different forms of NRT have emerged, providing individuals with diverse options tailored to their preferences and lifestyles. Below, we discuss five of the most popular and modern forms.
Nicotine gum
Nicotine gum is a popular and easily accessible form of NRT available over-the-counter. As outlined in this study, the gum has been a staple in smoking cessation efforts, hailed for its low cost, fast absorption (compared to transdermal patches), high bioavailability, easy consumption, availability in low doses, and fewer side effects. Recent findings also revealed unexpected cognitive benefits, noting improvements in visual processing among individuals using Nicorette gum. This finding adds an intriguing dimension to the potential cognitive advantages of NRT.
Nicotine lozenges
Nicotine lozenges represent another popular form of NRT. They entered the market in 2002, almost two decades after nicotine gum. These are hard candies or tablets containing controlled amounts of nicotine. As the lozenge dissolves in the mouth, nicotine is gradually released and absorbed through the lining of the mouth. This method provides users with a discreet way to manage cravings, and the variety of available flavors adds an element of choice to the smoking cessation journey.
Nicotine lozenges represent another popular form of NRT. They entered the market in 2002, almost two decades after nicotine gum. These are hard candies or tablets containing controlled amounts of nicotine. As the lozenge dissolves in the mouth, nicotine is gradually released and absorbed through the lining of the mouth. This method provides users with a discreet way to manage cravings, and the variety of available flavors adds an element of choice to the smoking cessation journey.
Nicotine pouches
The more recent nicotine pouches, released in the market in 2015, are known for their versatility and ease of use. Because of their novelty, prominent brands like ZYN get to leverage advanced distillation procedures to derive nicotine from the tobacco plant, instead of using synthetic nicotine that’s made in the lab. This ensures that the different flavors found on this site, from ZYN Wintergreen to Citrus, are of the highest quality. Otherwise, the pouches’ simple under-the-gum tucking process and absence of tobacco contribute to a stain-free experience for teeth, addressing a common concern associated with traditional tobacco use.
The more recent nicotine pouches, released in the market in 2015, are known for their versatility and ease of use. Because of their novelty, prominent brands like ZYN get to leverage advanced distillation procedures to derive nicotine from the tobacco plant, instead of using synthetic nicotine that’s made in the lab. This ensures that the different flavors found on this site, from ZYN Wintergreen to Citrus, are of the highest quality. Otherwise, the pouches’ simple under-the-gum tucking process and absence of tobacco contribute to a stain-free experience for teeth, addressing a common concern associated with traditional tobacco use.
Nicotine patch
The nicotine patch is a long-acting form of NRT that delivers a steady supply of nicotine through the skin. According to this guide by the CDC, combining the patch with fast-acting products like gum or pouches enhances its effectiveness in managing cravings and withdrawal symptoms. However, the key advantage of the patch is its convenience. When worn for 24 hours, it provides a continuous release of nicotine and can even be kept on during activities like showering. This method allows users to gradually decrease nicotine intake over several weeks, facilitating a smoother transition to a smoke-free life.
The nicotine patch is a long-acting form of NRT that delivers a steady supply of nicotine through the skin. According to this guide by the CDC, combining the patch with fast-acting products like gum or pouches enhances its effectiveness in managing cravings and withdrawal symptoms. However, the key advantage of the patch is its convenience. When worn for 24 hours, it provides a continuous release of nicotine and can even be kept on during activities like showering. This method allows users to gradually decrease nicotine intake over several weeks, facilitating a smoother transition to a smoke-free life.
Nicotine inhaler
Another option in the realm of NRT is the nicotine inhaler. This device mimics the hand-to-mouth ritual of smoking and delivers nicotine vapor to be inhaled. While not as popular as other forms of NRT, the inhaler provides a unique psychological aspect, addressing both the physical and behavioral components of smoking addiction.
While users can find comfort in the familiar gestures associated with smoking, the inhaler is only available upon prescription. However, individuals can opt for the more modern version of this tool: the oxygen inhaler. Popularized as Quitgo’s nicotine-free inhaler with a soft mouthpiece, this alternative banks on addressing the need for the physical gestures in the traditional cigarette smoking ritual. Prior research has shown a higher likelihood of quitting successfully at week 24 when the oxygen inhaler is used in cessation programs alongside psychological support and varenicline.
As research progresses and new products emerge, NRT products remain a beacon of hope for those looking to break free from the chains of tobacco addiction. For more news on health, check out our catalog on Digital Global Health.