Smokers’ Health: Quitting Smoking with Nicotine Replacement Therapy

Pharmacist recommending Nicotinell products

Smoking statistics

Tobacco is the leading cause of premature, preventable death in the world and kills up to 50% of its users.1

In 2019, 17% of the Irish population aged 15 or over smoked.2 The highest proportion of smokers are those aged 25-34 (26%).2

46% of people who had smoked in the last year made an attempt to quit in the previous 12 months and 25% of those have been successful.2

After the age of 35-40, a person will lose around 3 months of life expectancy for every year of continued smoking, reinforcing the importance of encouraging people to quit.3

Image of Nicotine binding onto nicotinic receptor sites

Quitting smoking is an uphill battle: Patients are fighting both physical and psychological addiction

Smoking induces an increase in nicotinic receptors in the brain.4 Quitting has both physical and psychological components.5 Physical withdrawal symptoms are the result of the body reacting to the absence of nicotine; psychological issues are the result of giving up the habit.5

Icons of facts

Help tilt the odds in your patient’s favour – the role of Nicotine Replacement Therapy

Helping patients to manage withdrawal symptoms plays a vital role in helping them quit smoking.

  • Only 4% of people are able to quit unaided5
  • These symptoms can last for up to 4 weeks6
  • 70-90% of smokers say withdrawal symptoms are the reason they don’t quit7

Nicotine Replacement Therapy (NRT) products are used to address physical cravings by providing a measured dose of nicotine, without the harmful ingredients found in tobacco. By providing nicotine in this way, the patient is supported in their quit attempt.

The Irish Department of Health recommends a combination of NRT formats as a first line option for the best results in patients who wish to use pharmacological support.8 A nicotine patch slowly releases nicotine at a constant level into your system and this can be combined with a fast-acting product such as a spray or lozenge to help deal with immediate cravings.

  • Image of skeleton showing where the smoke/nicotine travels

    Nicotine activates receptors in the brain that cause the release of chemicals which cause the smoker to perceive pleasure and/or less anxiety and tension.

    The brain gets used to these chemicals and wants the release to occur throughout the day to reproduce these positive sensations all the time.

    Physical nicotine withdrawal symptoms

    Withdrawal symptoms can start within a few hours of quitting, peak at about 2 to 3 days after quitting and may last up to several weeks.5 Symptoms include:10

    • Anxiety
    • Hunger
    • Irritability
    • Depressed mood
    • Restlessness
    • Insomnia
    • Difficulty concentrating
  • Speech bubbles of situational triggers
    • Smokers learn to associate smoking with certain behaviours involving people, places, activities and moods
    • These situational triggers can derail a quit attempt if quitters are not prepared

    Understanding psychological withdrawal

    Psychological withdrawal symptoms may be more difficult to overcome than physical symptoms. Triggers such as stress, being around other smokers or alcohol may result in intense cravings. As triggers may be unavoidable it is important to help quitters to understand how to handle them using distraction techniques such as changing drinks or chewing sugar free gum or avoiding places associated with triggers.

  • Women outside in nature

    There are many health benefits to be gained from smoking cessation

    Physical health benefits13

    • In 3-9 months, lung capacity increases by up to 10%, which can make breathing easier
    • In 2-12 weeks, blood circulation improves which can make physical activity easier
    • Immune system improves making it easier to fight off infections
    • Improved fertility
    • Oral health benefits including reduced risk of developing gum disease
    • Reduced risk of heart disease, lung cancer and chronic bronchitis
    • Increased life expectancy

    Mental health benefits14

    • Lower stress levels
    • Reduced anxiety
    • Reduced feelings of depression
    • Increased quality of life
    • Improvement in feelings of positivity
    • Benefits akin to taking antidepressants for mental health sufferers
  • Table explaining pharmacists to ask, advise and act

    A 30-second dialogue can have a positive impact on smoking15

    The Department of Health recommends that for the general adult population (aged 18+ years):8

    • All healthcare professionals should document individuals’ smoking behaviour
    • Advise them on the harms of smoking for themselves and others and the benefits of quitting
    • Advise that help can be provided/arranged to support a quit attempt
    • Advise that making an unsupported attempt to quit is less effective than using support

    You can help by informing patients about the options available to support their quit including NRT.

Willpower alone is considered to be the least effective method of smoking cessation8

Patch, gum and lozenge packshots

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