NRT Myths and Facts

It’s tough to quit smoking. Many smokers must try many times before they are able to quit for good. Your best chance for success occurs when you make a plan. Start by talking to your healthcare provider. They can help you decide what options you should consider. Research shows the best results are obtained when nicotine replacement therapies are combined with counselling.

The following myths and facts are taken from a June 1999 Ontario Medical Association report: Rethinking Stop-Smoking Medication: myths and facts. To view the report in full click on www.oma.org/Health/tobacco.

1. Myth: Stop-smoking medications are not effective in helping people quit.
   Fact: Nicotine Replacement Therapy (NRT) and bupropion (prescription drug) are effective, government-approved medications available to help smokers. NRT and bupropion have each been found to approximately double quitting rates compared to placebo.
2. Myth: Nicotine is the harmful substance in cigarettes.
   Fact: It’s not nicotine, but the thousands of toxins present in tobacco and its products, that are responsible for the vast majority of tobacco-caused disease.
3. Myth: Nicotine's addictive potential is the same regardless of whether nicotine is obtained through nicotine gum, the patch, or cigarettes.
   Fact: Cigarettes are far more addictive than nicotine gum or the patch primarily because of the way in which they deliver nicotine.
4. Myth: Nicotine replacement therapy is hazardous for smokers.
   Fact: Nicotine replacement therapy is safe for smokers.
5. Myth: Use of the nicotine patch and gum should not exceed 3 months.
   Fact: The nicotine patch and gum should be used as long as needed to maintain or prolong tobacco abstinence.
6. Myth: Smoking while on the patch increases the risk of a heart attack.
   Fact: Use of NRT while smoking does not increase the smoker's cardiovascular risk.
7. Myth: Patients with heart disease should not use the nicotine patch or gum.
   Fact: Given the seriousness of their medical condition, cardiac patients who cannot quit should be among those first considered for NRT. However, NRT dosage should be closely monitored by the physician.
8. Myth: Pregnant women should not use nicotine gum or the patch.
   Fact: NRT use may be considered for pregnant women who are unable to quit. However, as with all drugs used by pregnant women, NRT use during pregnancy should be closely monitored by the physician.
9. Myth: Smokers under 18 should not use NRT.
   Fact : Most daily smokers begin smoking before age 18. The nicotine patch and gum are far safer than smoking. NRT should be considered for all smokers who need NRT to quit, including those under 18. As with other medications for adolescents, the NRT dosage should be modified to the smoker’s needs.
10. Myth: The nicotine patch and gum should not be used at the same time and/or in combination with bupropion.
    Fact: The nicotine patch and gum may be used at the same time and/or in combination with bupropion. People using a combination of stop-smoking medications should be monitored by their healthcare provider.
11. Myth: NRT should only be taken in recommended doses.
    Fact: Smokers should be in control of how they use NRT and should vary the dose according to their own nicotine needs. Like smoking, it takes time to learn how best to use NRT in a manner that maximizes its benefits.
12. Myth Nicotine gum or the patch should only be used to quit smoking.
    Fact: Nicotine gum or the patch can be used by people who are not yet ready or able to quit as, for some individuals, being tobacco-free is not a foreseeable goal. NRT may help these smokers take a "cigarette holiday" or, in some cases, substantially reduce their smoking as an interim, achievable step toward tobacco abstinence.

From the Ontario Medical Association position paper, Rethinking Stop-Smoking Medications: myths and facts, prepared by Nicole de Guia, project manager and researcher, with direction and support from Dr. Ted Boadway, Patricia North, and Carol Jacobson of the Ontario Medical Association (OMA) Health Policy Department, and Michael Perley of the Ontario Campaign for Action on Tobacco.