There are several NRT options available to help address different nicotine cravings. Nicotine patches deliver nicotine through the skin into the bloodstream over 16-24 hours to prevent nicotine withdrawal symptoms. Gum and lozenges provide fast-acting nicotine relief during cravings by chewing or sucking on them. Inhalers and nasal sprays more closely mimic the hand-to-mouth ritual and sensory effects of smoking to help control cravings. Regardless of the delivery method, using NRT as directed can significantly reduce withdrawal symptoms and the urge to smoke.

Prescription Medications

For smokers who need additional support beyond NRT, prescription medications are available. Two types of prescription drugs are commonly used as Smoking Cessation and Nicotine De-addiction Products  aids - bupropion and varenicline. Bupropion, also known by the brand name Zyban, is an antidepressant that is thought to work by acting on the part of the brain involved with cravings and addictions. A course of bupropion therapy begins 1-2 weeks before the quit date and continues for 7-12 weeks after. Common side effects include dry mouth and insomnia.

Varenicline is the most recently approved prescription medication indicated for smoking cessation. Sold under the brand name Chantix, varenicline works by selectively binding to nicotinic receptors in the brain, reducing nicotine cravings and preventing the rewarding effects of nicotine from cigarettes. Treatment involves a 12-week regimen starting 1 week before the quit date. The most common side effects are nausea, headaches, difficulty sleeping and vivid/unusual dreams. Both bupropion and varenicline have been shown to nearly double quit rates compared to using NRT or willpower alone.

E-cigarettes and Smokeless Tobacco

While not approved medical therapies, some experts argue that e-cigarettes and smokeless tobacco products like snus pouches and chewing tobacco could also potentially help some smokers transition from burning tobacco to less harmful nicotine-containing alternatives. E-cigarettes deliver nicotine via vapor without all the cancer-causing chemicals in cigarette smoke. Early research shows they may help more smokers quit than traditional NRT alone. However, the long-term effects of vaping are still unknown.

Smokeless tobacco provides nicotine without smoke and is linked to less health risks than cigarettes. However, smokeless tobacco use still increases risks of cancer and cardiovascular disease compared to not using any tobacco products. Since these products are still addictive and harm reducing rather than harm free, health authorities debate whether recommending them to smokers seeking help is prudent. More research is needed to determine their true role in smoking cessation efforts.
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