Report in Brief
Smoking is both a learned behaviour and a physical addiction to nicotine, so treatment may consist of counselling, as well as drug therapy. Drug therapy options include bupropion, varenicline, and nicotine replacement therapy (NRT).
NRT is available in several forms, including patches, gum, inhaler, lozenge, nasal spray, and sublingual tablets (tablets that dissolve under the tongue).
As well, NRT is being used in higher-than-recommended doses, and is being used to reduce smoking in people who do not intend to quit.
A review of the evidence will help inform decisions about new NRT products, high-dose NRT, and using NRT to reduce smoking.
- What is the clinical effectiveness of newer nicotine replacement products (Nicorette Quick Mist, Nicorette Combo Quit, Nicorette Mini Lozenges) for smoking cessation?
- What is the clinical evidence for the use of supratherapeutic doses of nicotine replacement therapy?
- What is the clinical evidence for the use of nicotine replacement products to reduce smoking for those who do not quit?
No clinical evidence was identified for the NRT products specifically termed as the Nicorette Quick Mist, Nicorette Combo Quit, or Nicorette Mini Lozenges. Limited evidence showed that nicotine mouth spray or the combination of nicotine patch plus gum achieved higher smoking cessation than placebo. Modestly higher smoking cessation rates were observed with high doses nicotine patch compared with standard nicotine patch dose. NRT appears effective in reduction of smoking for those who did not want to quit. However, findings reported in this review should be interpreted with caution due to the potential methodological limitations and clinical heterogeneity of the body evidence. Better designed RCTs in Canadian settings are needed to determine the clinical effectiveness of the newer NRT products or the use of high doses of NRT for smoking cessation, as well as the role of NRT in smoking reduction.