Smoking Cessation  |  NRT patches, gum, and lozenges are available on prescription from July 2009.




Smoking Cessation

NRT patches, gum, and lozenges are available on prescription from July 2009.

NRT will also still be available on the Quit Card scheme. In general, let people decide which product they would like to use. Combination of patch and gum or lozenge is safe and may increase the likelihood of quitting.

 

Patch (24 hr)

Gum

Lozenge

Product Information:

Three strengths
(21 mg full strength, 14 mg medium, and 7 mg low).

Two strengths

(2 mg and 4 mg).

Two strengths

(1 mg and 2 mg).

DOSAGE for smokers of 10 or more cigarettes/day

Prescribe nicotine patch 21 mg/24 hr and/or nicotine gum or lozenge.

Dose of gum and lozenge depends on time to first cigarette:

  • if <30 minutes after waking use 4 mg gum or 2 mg lozenge
  • if >30 minutes after waking then 2 mg gum or 1 mg lozenge

If using a combination the gum/lozenge can be used as required. If using only gum/lozenge then recommend regular (e.g. hourly) use.

Note: lower strength patches are generally used for weaning, but their use is not strictly necessary.

DOSAGE for smokers of less than 10 cigarettes/day

Prescribe nicotine gum or lozenge in the first instance so that more or less can be used as needed.

Dose of gum and lozenge depends on time to first cigarette:

  • if <30 minutes after waking = 4 mg gum or 2 mg lozenge
  • if >30 minutes after waking then 2 mg gum or 1 mg lozenge

If the person cannot tolerate and oral product use a 14 mg nicotine patch/day but note that this may need to be increased to a 21 mg patch if the person still has a desire to smoke.

All products should be used for 8-12 weeks, or longer for some people. People should use enough so they get relief from withdrawal symptoms.

Instructions for Use:

Apply patch to clean, dry and hairless skin. Remove old, and apply new patch daily, alternating sites. (Some redness under the patch does occur.)

Chew to release taste and then park in the side of the mouth (between cheek and gums). Chew again when the taste starts to fade. Do this for 30 minutes and then discard.

Suck to release taste, and then park in the side of the mouth (between cheek and gums). Suck again when the taste starts to fade. Do this for 30 minutes and then discard.

What to write on the prescription or Quit Card

If combining products, write one Quit Card for each.

Nicotine Patches 21 mg - please supply four boxes.

Nicotine Gum 2 mg (or) 4 mg - please supply four boxes.

Nicotine Lozenges 1 mg (or) 2 mg - please supply six boxes.

 

Notes about NRT:

  1. The number of cigarettes smoked per day is not the best indicator of tobacco dependence. People can reduce consumption, but typically compensate by smoking their fewer cigarettes more intensely. A better indication of dependence is time to first cigarette after waking. Those who smoke within 60 minutes of waking show greater dependence than those who smoke after 60 minutes of waking.
  2. NRT can be used in pregnancy (following a risk-benefit assessment). Using NRT is less risky than continuing to smoke during pregnancy (see page 49 of the Smoking Cessation Guidelines for more information).
  3. NRT is safe to use in people with cardiovascular disease. No dosage adjustment is needed.
  4. NRT can be used in adolescents (aged 12 and over). Use the product best suited to their needs.
  5. Sublingual tablets (Microtabs) and inhalers are available in pharmacies (see page 41 of the Smoking Cessation Guidelines). These medications are not subsidised and not available through the Quit Card.
  6. There are no drug interactions with NRT. However the doses of some medicines (for example, some psychiatric medicines) may need a dosage adjustment when people stop smoking (see page 50 of the Smoking Cessation Guidelines).
  7. Nicotine overdose with NRT is very rare.


Last updated : Friday, July 29, 2016
Next review date : Saturday, July 29,2017


Disclaimer: This site is intended to be flexible and frequently updated. While every effort has been made to ensure accuracy, all information should be verified.