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How Nicotine Replacement Therapy (NRT) Works: Frequently Asked Questions

Where can I buy Nicotine Replacement Therapy (NRT) products?

You can buy NRT products over the counter, without needing a prescription. They can be purchased from pharmacists, and some types are available at supermarkets and petrol stations.

Nicotine patches are also available on the Pharmaceutical Benefits Scheme (PBS), as a 12-week supply, once in a 12-month period (twice in a 12-month period for Aboriginal people and Torres Strait Islanders).

For more information, visit the PBS website at www.pbs.gov.au or call the PBS Information Line on 1800 020 613.

Can I buy a generic or cheaper version of an NRT product?

In Australia, nicotine patches, gum and lozenges are currently available in different brands. The prices of these products vary considerably, depending on the brand and where you buy them. There is no evidence that one brand is more effective than another.

The nicotine inhaler (inhalator) and mouth spray do not come in different brands, however the prices of these products can still vary considerably depending on where you make your purchase. It pays to shop around!

Which NRT product is the most effective?

There is generally little difference between the effectiveness of each type of NRT product in helping people quit. For example, the lozenge is just as effective as the patch, while the gum is just as effective as the inhaler (inhalator) at increasing quitting chances. However, some NRT products may alleviate cravings quicker. The decision of which type of product to use is often based on personal preference.

One factor that does alter the effectiveness of nicotine replacement therapy products is the way in which you use them. To get the maximum benefit from your NRT, it’s important to use the product as instructed.

In particular, you need to ensure you provide yourself with the correct (therapeutic) dose. ‘Under-dosing’ is common, which means users do not get the full benefit from their NRT.

How long should I use Nicotine Replacement Therapy for?

NRT should be used daily for a minimum of 8 weeks, however usage up to 12 weeks is standard. It’s important to note that stopping NRT before 8 weeks reduces its effectiveness.

A small minority of users may benefit from extended use after quitting (e.g. a number of months), however this is not the case for most people. If you are considering extended NRT use, you should talk to your GP or pharmacist about this first.

How much nicotine do NRT products contain?

NRT products contain smaller amounts of nicotine than a typical daily smoker would receive from smoking. For example, the 2mg nicotine gum typically provides considerably less than half the amount of nicotine compared to one cigarette. Therefore, some withdrawal symptoms may still be noticeable when you use NRT to quit smoking.

Can I skip my NRT usage on days when I feel I’m managing okay?

To minimise withdrawal symptoms, it’s important to take the correct amount of nicotine replacement therapy and not skip certain days. Skipping days or trying to manage cravings without using NRT correctly tends to make it harder, not easier, to remain a non-smoker.

What side effects might I experience when using NRT?

Unwanted side effects of nicotine replacement therapy are generally mild and are not serious. Often, symptoms that are attributed to NRT use are actually nicotine withdrawal symptoms, due to the reduced amount of nicotine in NRT products compared to tobacco.

Nausea can be a sign of too much nicotine, but this is very uncommon if you use the correct dose.

Generally, side effects will be specific to a particular NRT product. For example, a nicotine patch might cause skin irritation, while oral NRT can produce hiccups in some people.

To find out more about common side effects of each NRT product, it’s best to read the information about the specific type of product, or talk to your GP or pharmacist.

Doesn’t NRT cost too much?

The cost for a week’s supply of NRT should always work out cheaper than the cost of smoking.

For example, a packet-a-day smoker would expect to spend between $20 and $50 (AUD) for one week’s supply of NRT purchased at a pharmacist (depending on the product they choose).

It’s important to remember that you’ll only be paying for NRT for around 8-12 weeks – it’s not an ongoing cost like that of continued smoking.

You can also buy a 12-week supply of nicotine patches on the Pharmaceutical Benefits Scheme (PBS). This supply can be purchased once in a 12-month period (twice in a 12-month period for Aboriginal people and Torres Strait Islanders) and is usually a script with two repeats.

Purchasing patches through the Pharmaceutical Benefits Scheme usually works out cheaper than buying them over the counter. However, participation in a comprehensive support program such as the NSW Quitline is required when accessing patches on the PBS.

For more information, visit the PBS website at www.pbs.gov.au or call the PBS Information Line on 1800 020 613.

Can I swap the type of NRT product I use? For example, can I use a nicotine patch for 4 weeks, then switch to nicotine gum?

Yes, you can. The goal of NRT is to manage your withdrawal symptoms and cravings; all nicotine replacement products are designed to do this. The most important consideration is maintaining the correct dose.

Can I use NRT with the prescription medication Bupropion (Zyban)?

Yes. Click here to find out more about the prescribed quit smoking medication, Bupropion (Zyban).

Can I use NRT with the prescription medication Varenicline (Champix®)?

Combining NRT with Varenicline (Champix®) is not currently a recommended approach.

At this stage, any long term advantages and safety of this combination remain unknown.

Click here to find out more about Varenicline (Champix®).

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