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A guide to nicotine replacement therapy products and dosages

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The following guide suggests nicotine replacement therapy (NRT) products based on levels of nicotine dependence.

Low dependence. May benefit from using NRT occasionally.
Nicorette / Nicotinell / NiQuitin CQ
2mg gum – original, mint, fresh fruit, fresh mint, Icy White
Inhalator (15mg)
2mg Microtab – 1 per hour
Cools Lozenge (2mg)
QuickMist (1mg per spray). / 2mg gum – mint, fruit, liquorice
1mg lozenge / 2mg gum – mint
2mg lozenge
1.5mg Minis – Mint, Cherry.
2.5 mg Oral strips
Medium dependence. If smoking at regular intervals during the day recommend - either a 16 or 24-hour patch. Alternatively with less regular smoking pattern suggest low strength intermittent product – gum, microtabs, lozenge or inhalator where hand-to-mouth action of smoking is likely to be missed.
Nicorette / Nicotinell / NiQuitin CQ
15mg 16-hour patch - beige
2mg gum – original, mint, fresh fruit, fresh mint
Inhalator (15mg)
2mg Microtab – 1 per hour
Cools Lozenge (2mg)
QuickMist (1mg per spray). / 14mg 24-hour patch - beige
2mg gum – mint, fruit, liquorice
2mg lozenge - mint / 14mg 24-hour patch – clear or beige
2mg gum – mint
2mg lozenge
1.5mg / 4mg Mini – mint
2.5 mg Oral Strips
High dependence. Smoking regularly during the day and within 30 minutes of rising – either a 16 or 24-hour patch. For intermittent and supplementary use - full strength gum, inhalator, nasal spray, microtab or lozenge.
Nicorette / Nicotinell / NiQuitin CQ
25mg 16-hour patch - clear
4mg gum – original, mint, fresh fruit, fresh mint, Icy White
2mg Microtab – 2 per hour
Nasal spray. Cools Lozenge (4mg)
QuickMist (1mg per spray). / 21mg 24-hour patch – beige
4mg gum – mint, fruit, liquorice
2mg lozenge - mint / 21mg 24-hour patch – clear or beige
4mg lozenge / Mini – mint
2.5 mg Oral strips
In trials, a combination of two different NRTs was in general more effective than a single NRT (normally patch and another format).
Very high dependence. Products as for high dependence. If using an intermittent product, nasal spray provides the fastest delivery for nicotine.

16-hour patch / 24-hour patch: points to consider

·  Both patches have been shown to be equally effective.

·  16-hour patches are designed to mimic the average smoker’s daily habit, minimising the risk of sleep disturbance.

·  The manufacturers of 24-hour patch state that a 24-hour patch is used to optimise the effect against morning cravings. However, studies have shown that a higher percentage of relapses occur afternoon/evening and not mornings.

Suggested prescribing for two-week nicotine replacement therapy (NRT) supply

Brand /
Supplied in
/ 2-week supply
(half quantity if combination with patches)
Nicorette 16-hour patch
Clear patches / 7 x 25mg (clear only)
7 x 15mg (clear only)
7 x 10mg (clear only) / 2 x 7 chosen product
Regime: 25mg x 8 weeks, 15mg x 2 weeks, 10mg x 2 weeks.
Nicotinell 24-hour patch
Beige patches / 7 x 21mg
7 x 14mg
7 x 7mg / 2 x 7 chosen product
Regime: 21mg x 3-4 weeks, 14mg x 3-4 weeks, 7mg x 3-4 weeks
NiQuitin CQ 24-hour patch
Beige or clear patches / 14 x 21mg
7 x 21mg
7 x 14mg
7 x 7mg / 2 x 7 chosen product
or 14 x 21mg
Regime: 21mg x 6 weeks, 14mg x 2 weeks, 7mg x 2 weeks
Nicorette 2mg gum / 15, 30, 105 / 2 x 105
Nicorette 4mg gum / 15, 30, 105 / 2 x 105
Nicotinell 2mg gum / 12, 48, 96 / 2 x 96
Nicotinell 4mg gum / 12, 48, 96 / 2 x 96
NiQuitin CQ 2mg gum / 48, 96 / 2 x 96
NiQuitin CQ 4mg gum / 48, 96 / 2 x 96
Nicotinell 1 & 2mg lozenge / 12, 36, 96 / 1 x 96
NiQuitin CQ 2mg lozenge / 36, 72 / 3 x 72
NiQuitin CQ 4mg lozenge / 36, 72 / 3 x 72
Nicorette microtab / 30, 105 / Low to medium dependence
2 x 105 pack / High dependence
3 to 4 x 105 packs
Nicorette inhalator
15mg cartridges / Refill pack 36 cartridges / Low dependence
2 x refill Pack
Medium dependence
3 to 4 x refill packs
Nicorette nasal spray / 200 spray bottle / 2 - 4 bottles nicotine nasal spray
NiQuitin Minis 1.5mg and 4mg / 20, 60 (1 x 60) / 2 x 60
Niquitin Oral Strips / 15, 60 (2.5mg) / 2 x 60
Nicorette Cools Lozenge 2mg / 80 / 2 x 80
Nicorette Cools Lozenge 4mg / 80 / 2 x 80
Nicorette QuickMist 13.2ml (150 sprays per bottle) / 1 x 13.2ml & 2 x 13.2ml / 2 x 13.2ml
Summary

·  All formulations of nicotine replacement therapy (NRT), Bupropion and Varenicline have been shown to be significantly more effective than placebo in helping smokers quit.

·  NICE guidance should be followed when considering treatment to aid smoking cessation.

Points to remember

·  Refer smokers to the smoking cessation service or registered smoking advisor(s).

·  Use the most cost-effective product that is best suited to the smoker’s needs and/or preferences.

·  Smokers must demonstrate their quit attempt is continuing before a second prescription is given.

References: National Institute for Clinical Excellence (NICE). Technology Appraisal Guidance No. 39. Guidance on the use of nicotine replacement therapy (NRT) and Bupropion for smoking cessation. March 2002. Technology Appraisal No. 123. Varenicline for smoking cessation. July 2007

Updated: September 2015