Nicotine Replacement Therapy.  Is it right for you?

Nicotine replacement therapy (NRT) helps reduce nicotine withdrawal symptoms and nicotine craving by supplying your body with nicotine. Most NRT products contain about one third to one half the nicotine found in cigarettes.

Nicotine Replacement Therapy

Your odds of stopping smoking are best when you combine nicotine replacement therapy with a complete smoking cessation program that includes setting a quit date, having a plan in place for dealing with smoking triggers, and getting support from a doctor, counselor, or support group.

One Nicotine Replacement Study Noted the following items from individuals using various methods of NRT

Ninety-two RCTs involving 32,185 participants and 28 observational studies involving 145, 205 participants were identified. Pooled RCT evidence of varying NRT formulations found an increased risk of heart palpitations and chest pains (OR 2.06, 95% Confidence Interval [CI] 1.51-2.82, P < 0.001); nausea and vomiting (OR 1.67, 95% CI 1.37-2.04, P < 0.001); gastrointestinal complaints (OR 1.54, 95% CI, 1.25-1.89, P < 0.001); and insomnia (OR 1.42, 95% CI, 1.21-1.66, P < 0.001). Pooled evidence specific to the NRT patch found an increase in skin irritations (OR 2.80, 95% CO, 2.28-3.24, P < 0.001). Orally administered NRT was associated with mouth and throat soreness (OR 1.87, 95% CI, 1.36-2.57, P < 0.001); mouth ulcers (OR 1.49, 95% CI, 1.05-2.20, P < 0.001); hiccoughs (OR 7.68, 95% CI, 4.59-12.85, P < 0.001) and coughing (OR 2.89, 95% CI, 1.92-4.33, P < 0.001). There was no statistically significant increase in anxiety or depressive symptoms associated with NRT use. Non-comparative observational studies demonstrated the prevalence of these events in a broad population.


The use of NRT is associated with a variety of side effects. In addition to counseling and medical monitoring, clinicians should inform patients of potential side effects which are associated with the use of NRT for the treatment of tobacco dependence.

The prevalence of heart palpitations and chest pains were reported sporadically and amounted to 3.6% of the populations examined. Coughing was reported as a prevalence of 8.1%.

Serious adverse events were poorly reported in the observational studies. However, one study reported on a case of transient visual field impairment; one right-hemisphere stroke; one myocardial infraction; and one urticarial reaction from skin patch with symptoms of angiodema. Finally, in a single large observational study of self-harm (n = 63,265), 141 cases of fatal and non-fatal self-harm cases were identified (0.2%), in addition to 30 cases of suicidal ideation.

This review found that NRT is associated with an increased risk of gastrointestinal complaints and insomnia. There was also an observed increased risk of skin irritation with the nicotine patch and oropharyngeal complaints with orally administered NRT. Although NRT was associated with an increased risk of heart palpitations, the review did not observe an increased incident of heart attack or death. With the exception of insomnia, NRT does not appear to be associated with serious adverse psychiatric effects.

Vancouver Sun Report on Champix & Suicide

Champix is suspected of playing a major role in the deaths of 44 patients — 30 of them by suicide — since the popular stop-smoking drug was approved in Canada in 2007, a Vancouver Sun investigation has found.

The Pfizer drug has also been linked to more than 1,300 incidents of suicide attempts or thoughts, depression, and aggression/anger across the country in the past seven years.

The drug is the most popular of those offered by B.C.’s quit smoking program, which traditionally sees a jump in participation every January as people renew new year’s resolutions to butt out.

B.C’s Ministry of Health fires PhD Student over Study of anti-smoking program.

When PhD student Roderick MacIsaac was fired from the Ministry of Health, his study of an anti-smoking program that was to be used in the evaluation of B.C.’s controversial Smoking Cessation Program was halted.

MacIsaac was one of seven ministry health researchers terminated in 2012, and he committed suicide in the months that followed.

Since then, the government has apologized for MacIsaac’s “heavy-handed” dismissal and has rehired or settled lawsuits with the majority of the other workers.

MacIsaac’s program evaluation did not continue despite evidence that the two pharmaceutical drugs covered by the provincial smoking cessation program, launched in 2011, can cause severe adverse reactions in patients, including death.

Use of a popular smoking cessation and depression medication led to 64 hospitalizations — including 22 cases admitted to critical care — last year in B.C., according to the province’s Drug and Poison Information Centre.


Pro's and Con's of Quitting Smoking

To enhance motivation to quit smoking, each person should try to identify their own personal pros and cons of smoking and quitting. Making a plan and setting a date are two important factors in ending your addiction.