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Microtab
Available on prescription only, the Microtab is placed under the tongue where it is left to dissolve (for about 20-30 minutes). It allows a steady dose of nicotine to be slowly absorbed through the lining of the mouth (not through the stomach which absorbs nicotine much less efficiently).
Heavy smokers need to use approx 16-40 a day (lighter smokers 8-12 a day) for a least 12 weeks, then tail off slowly.
The advantage is they are discreet and esy to use, and have few side effects. Also, the dose can be easily adjusted, so you can use a Microtab when you get the urge to smoke. However, as with all NRT you should take Microtabs regularly, regardless of whether you experience cravings.
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Nasal Spray
Best-suited to heavy smokers, Nicotine Nasal Spray is the fastest-acting form of NRT and is now available over the counter in pharmacies.
To use, the nozzle of the small spray bottle is inserted into one nostril then the other, and squeezed.
The recommened dose is once or twice an hour in each nostril over a period of 10 weeks, followed by 2 weeks of half the dose.
The main advantage of the spray is that it provides the fastest possible 'hit' of nicotine when you get a craving. On the down side, nicotine spray does carry a small risk of dependence and it is not very discreet to use. The inital side effects of itchy, runny nose, watery eyes and sneezing usually wear off after 48 hours.
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Nicotine Gum
Nicotine gum supplies a faster 'hit' of nicotine than the patches, giving you bursts of nicotine at regular intervals throughout the day. Its biggest drawback is that people often fail to use enough of it to keep a steady level of nicotine in the bloodstream. It should therefore be chewed regularly and not ONLY when you get the urge to smoke.
One of its advantages is that you can regulate the dose, ie you chew it when you get the urge to smoke, but you should chew 10-15 pieces a day regardless of whether you experience cravings. Also, if you have a tendency to snack instead of smoking, having gum to chew may be helpful.
It is also important to chew it correctly. The nicotine needs to be absorbed through the lining of the mouth, so you should chew for a while to release some of the nicotine then let it rest in your cheek before chewing again, and so on. If you chew it too fast you swallow too much of the nicotine and it is wasted as the stomach does not absorb it well.
Many people don't like the taste at first, and it can irritate the throat, but if you persevere you do get used to it.
Different flavours of gum are now available, in two strengths - 4mg for heavy smokers and 2mg for lighter smokers.
(Not recommended for people with dentures).
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Nicotine Inhaler or Inhalator
The Inhalator is available on prescription only. It looks and feels like a plastic cigarette holder, into which you insert a foam plug containing nicotine. The user sucks on the inhalator in much the same way as you would a cigarette, getting about 1 tenth of the nicotine you would normally get from a puff on a cigarette.
It is normally recommended for light to medium smokers who can't get on with patches or gum, particularly those who miss having something to do with their hands. Its main advantage is that it feels vaguely similar to a cigarette - although this may or may not be a good thing! Also, you can regulate the dose, ie you can use it when you get the urge to smoke, but as with all NRT, once you've started the course you should use it regardless of whether you experience cravings.
As with gum, the Inhalator may be helpful if you have a tendency to snack as it gives you something to put in your mouth.
The recommended dose is 6-12 cartridges a day. You use the Inhalator on the full dose for up to 8 weeks, then reduce the dose by half for a further 2 weeks, making a total of 10 weeks.
Not recommended for heavy smokers, nor for the very self-conscious as it tends to attract attention when you use it.
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Nicotine Lozenges
Lozenges are sugar-free and come in various flavours and should be sucked, not chewed, to allow a steady dose of nicotine to be slowly absorbed through the lining of the mouth (not through the stomach which absorbs nicotine much less efficiently).
The recommended dose is between 8-12 a day (but not more than 25), which should be continued for at least 12 weeks before tailing off slowly.
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Nicotine Patches
The big advantage with patches is that they are easy, convenient and discreet to use, and its almost impossible to get the dose wrong (which does happen with other methods). Patches supply you with a steady dose of nicotine throughout the day, and are suitable for both heavy and light smokers.
Most are 24-hour patches, the advantage being that you don't wake up with a nicotine craving. However, some people suffer from sleeplessness as a result of being unused to nicotine in their body at night, so 16-hour patches are available.
If you smoke 20+ a day you start with the largest (highest dose) patch for the first few weeks, moving on to a smaller one for Stage 2 for the next couple of weeks, and tailing off with the smallest at Stage 3, the final stage.
If you smoke less than 20 a day you usually start at Stage 2, the intermediate strength.
A FEW people develop a skin reaction to patches.
TOP TIP It takes up to 8 hours for the required amount of nicotine to be absorbed into your bloodstream via a patch so put the first patch on at bedtime the night before so you don't wake up with a mega nicotine craving in the morning.