Treatments for Nicotine Addiction - Nicotine Replacement

Question 1

What is nicotine replacement therapy (NRT)?

Answer 1

A medically approved way to take nicotine by means other than tobacco

Can be prescribed by a doctor or bought over the counter

Question 2

Where is NRT available?

Answer 2

Available free on the NHS or at the cost of a prescription (£9.15) which is a third cheaper than if the products were bought in a pharmacy

Question 3

What is the aim of NRT?

Answer 3

Aims to stop or reduce the physical symptoms of nicotine withdrawal (such as cravings) and gradually reduce the number of nicotine receptors a smoker has

Question 4

Who is NRT most beneficial for?

Answer 4

Most beneficial for heavy smokers who smoke more than 15 cigarettes per day

Question 5

What are the different types of NRT?

Answer 5

Types of NRT include:

• adhesive patch
• chewing gum
• lozenges
• nose and mouth spray

Question 6

What differences between the different types of NRT?

Answer 6

Provide different ways in which nicotine is delivered to the body

How long it takes for the nicotine to enter the body

Total time nicotine stays in the body

Question 7

How do nicotine patches work?

Answer 7

Nicotine patches are applied to the skin and continuously administer a stable dose of nicotine slowly over 16-24 hours

Question 8

Why do smokers combine the patch with other NRT products?

Answer 8

Nicotine gum, sprays and lozenges administer nicotine orally with quicker nicotine reuptake into the body but lasting a shorter amount of time

Useful as they deal with cravings quickly

Question 9

What is the most effective way of using NRT?

Answer 9

Combing the use of patches and sprays with counselling or support from a doctor, nurse, pharmacist or stop smoking clinic

Eclectic approach - NRT deals with physical symptoms and counselling helps with psychological withdrawal symptoms

Question 10

How long should NRT be used for?

Answer 10

Should be used for at least 8-12 weeks for the best chance of stopping smoking in the long term

Gives the brain time to reduce the number of nicotine receptors

Dose is usually reduced in the later part of the course and then stopped

Question 11

What is the supporting evidence/strengths of NRT as a treatment for nicotine addiction?

Answer 11

NHS studies

Zhang (2015)

Stead (2012)

Psychology in society

Question 12

What is the refuting evidence/weaknesses of NRT as a treatment for nicotine addiction?

Answer 12

Kotz (2014)

Side effects

Doesn’t address cause of addiction

Ethical issues

Social control

Question 13

Why is NHS studies supporting evidence of NRT as a treatment for nicotine addiction?

Answer 13

NHS studies show NRT does increase the change of quitting smoking

Studies compared NRT to a similar placebo product in people who were keen to stop smoking

Results showed that, on average, about 17 in 100 people who took NRT stopped smoking successfully

Question 14

Why is Zhang (2015) supporting evidence of NRT as a treatment for nicotine addiction?

Answer 14

Zhang used data from a longitudinal study of 3,968 smokers in Ontario to show that NRT did help when stopping smoking but was only effective if used for 8-12 weeks as recommended

Question 15

Why is Stead (2012) supporting evidence of NRT as a treatment for nicotine addiction?

Answer 15

Stead also found evidence for the benefits of NRT suggesting it increased the rate of quitting by 60%

Was particularly true when two forms of NRT were combined such as patch and spray

Question 16

Why is psychology in society a strength of NRT as a treatment for nicotine addiction?

Answer 16

Understanding how NRT can help smokers quit is a good example of psychology in society

Employers that hire smokers bear indirect costs, including employee absenteeism etc.

Furthermore, a study found that people who were exposed to smoke in the workplace were 17% more likely to develop lung cancer than those not exposed

Therefore, it’s in the companies best interests to tackle smoking in the workplace

Question 17

Why is Kotz (2014) refuting evidence of NRT as a treatment for nicotine addiction?

Answer 17

Kotz in a cohort study of 1560 UK smokers found that NRT bought over the counter was associated with lower rates of abstinence after 6 months compared to a combined treatment of prescribed medication and behavioural support

Question 18

Why is side effects a weakness of NRT as a treatment for nicotine addiction?

Answer 18

Side effects associated with using NRT may affect the compliance rate in patients who find that costs of the treatment outweigh its benefits

e.g. when using patches the patient may experience skin irritation

In addition to this more general side effects include insomnia, dizziness and headaches

Question 19

Why is that fact it doesn’t address the causes of addiction a weakness of NRT as a treatment for nicotine addiction?

Answer 19

NRT alone doesn’t address the causes of addiction and is therefore prone to have high rates of relapse over time

e.g. if the addiction is caused by personal or social issues these may still be there and the individual may not have learned coping skills to deal with these

Question 20

Why is ethical issues a weakness of NRT as a treatment for nicotine addiction?

Answer 20

A choice has to be made by the NHS as to whether preventative measures such as NRT are worth spending money on in the hope they may reduce future cases of smoking-related illnesses which cost the NHS millions each year

Some individuals object to NRT being available free on the NHS or at the cost of a prescription as smoking is a choice and therefore smokers should choose to stop to improve their health

Question 21

Why is social control a weakness of NRT as a treatment for nicotine addiction?

Answer 21

The world’s most medication dependent cessation program is UK NHS Stop Smoking Services

The programs main aim is to use an advisor to tell smokers about nicotine replacement products and other stop smoking medicines

A review of this program suggests that medication use is all but forced upon participants. Some people see this as a lack of choice and that trained professionals are using their authority to force patients to use NRT