when you quit smoking, consider consuming more nicotine, not less

When it is routed through cigarettes, nicotine is considered one of the most addictive substances on Earth. So it may seem odd to suggest that people should use more, rather than less, to stop smoking. A recent research study, however, found this.

Nicotine replacement therapy, called NRT, has been helping people quit smoking safely for over 20 years. It can be prescribed by a doctor but, in many countries, is also available in grocery stores and pharmacies. The Cochrane Review (Cochrane Evaluates Evidence on Health Interventions and Summarizes Findings) examined the best ways to use NRT to stop smoking – and found three ways to use more nicotine to help:

• Use two forms of TRN rather than one. NRTs are available in different forms: skin patches, chewing gum, nasal and oral sprays, inhalers and lozenges. There is high-quality evidence that sticking a patch while using another form of NST, such as gum, increases your chances of quitting.
• Start using NRTs before quitting. Usually, people start using NRT on the day of their stop. But starting to use TNS a few weeks before, while they're still smokers, can help more people quit successfully.
• Higher doses of NRT may help some people. Some NRTs release higher levels of nicotine than others. In the studies reviewed, people were more likely to quit smoking if they used 4 mg, compared with 2 mg of nicotine gum. The higher dose may be particularly useful for people who smoke more cigarettes – for example, more than 20 per day. Evidence also suggests that the use of 21mg or 25mg patches could increase the risk of quitting compared to the use of 14mg or 15mg patches.

But why?

There are several good reasons why using nicotine in this way may be the solution rather than the problem.

First, it can make cigarettes less pleasant. Smokers find it pleasant to smoke because nicotine cigarettes make the brain release dopamine – a "happy" hormone. The brain is used to that. So, when a smoker has not smoked for a while, he begins to experience unpleasant symptoms, such as cravings, sleep problems, and mood changes.

NRTs provide the brain with an alternative source of nicotine, which alleviates these symptoms. When TNS is used before quitting, brain receptors are already filled with nicotine when a cigarette is smoked. As a result, the smoker does not enjoy the usual pleasure of smoking, which breaks the link between smoking and feeling good.

Second, NRTs replace a harmful way of delivering nicotine through a safe alternative. Some people may be concerned that taking more nicotine will cause side effects. Fortunately, NRTs are considered safe and this review found no evidence of overdose in NRT if they were used according to instructions.

Smoking is dangerous because of the many harmful chemicals found in cigarette smoke, including arsenic and formaldehyde. None of these are present in NRTs.

Finally, NRTs are not as addictive as smoking. Some people fear becoming dependent on NRT. But the way cigarettes deliver nicotine makes them much more dependent than NRTs. Cigarettes bring nicotine to the brain extremely quickly, along with other chemicals, which increase the strength with which nicotine affects the brain. Since nicotine from NRTs is transmitted to the brain much more slowly and without these additional chemicals, smokers do not experience the same quick pleasure when they use NRTs. This makes NRT less addictive.

Quitting smoking is difficult, but important – even people who have been smoking for many years can improve their health by quitting smoking. The problem with nicotine is that it is addictive to cigarettes, but it is cigarettes – not nicotine – that kills.

In 1976, prominent professor Mike Russell wrote: "People smoke for nicotine but die from tar." This is as true today as ever and it has been proven that a larger amount of nicotine could be part of the solution.

This article is republished from The Conversation under a Creative Commons license. Read the original article.