Journal of Medicine, Radiology, Pathology & Surgery (2018), 5, 6–8 6 Journal of Medicine, Radiology, Pathology & Surgery ● Vol. 5:1 ● Jan-Feb 2018 REVIEW ARTICLE Nicotine replacement therapy: A review C. K. Sumana, Tejavathi Nagaraj, Haritma Nigam, Sita Gogula, Swati Saxena Department of Oral Medicine and Radiology, Sri Rajiv Gandhi College of Dental Sciences, Bengaluru, Karnataka, India Abstract Nicotine replacement therapy (NRT) involves using diferent types nicotine delivery methods which replace the efects of nicotine obtained from smoking. NRT helps people who are willing to quit the habit. They crave straight into the bloodstream without producing the harmful efects produced by the chemicals present in the smoking forms. It aims to decrease the withdrawal symptoms associated with smoking. This article narrates various dosage forms of NRT. Keywords: Addiction, dependence, nicotine replacement therapy products, safety of products Correspondence: Dr. C. K. Sumana, Department of Oral Medicine and Radiology, Sri Rajiv Gandhi College of Dental Sciences, Bengaluru - 560 032, Karnataka, India. Phone: 91+9901034300. E-mail: drsumanack83@yahoo.com Received: 11 November 2017; Accepted: 19 December 2017 Doi: 15713/ins.jmrps.117 Introduction Smoking is a most common habit found in population. Nicotine is a main ingredient found in tobacco. Nicotine is a plant alkaloid derived from plant belonging to the family Solanaceae. Cessation of smoking habit improves quality of life, reducing the rate of morbidity, and also treatment expenditure of possible advanced diseases caused by smoking habit. Various modalities are used for cessation of smoking starting from the counseling of the person. Nicotine replacement therapy (NRT) is the most commonly used formulation of nicotine to stop the habit of smoking. It includes various forms of nicotine delivery methods meant to replace the nicotine obtained from smoking or other forms of tobacco usage and helps the patient to deal with the sequence of withdrawal symptoms. [1] Nicotine causes addiction in most of the smokers. Most of the patients who are willing to quit the habit sufer from withdrawal symptoms. NRT is the method of choice for such persons. Various nicotine dosage formulations are available as chewable gum, oral and nasal sprays, inhalers, patches, and sublingual tablets. NRT Products Nicotine gum Nicotine polacrilex (nicotine gum) was the frst commercially available NRT product. It delivers nicotine transmucosally. Nicotine gum is chewed intermittently and retained in the mouth for approximately 30 min for the release of nicotine. It is available in both 2 mg and 4 mg dosages. More success rate of withdrawal was achieved with 4 mg chewable gum. The number of doses per day is reduced gradually after a few weeks or months until it is no longer required. Patients should avoid acidic beverages (e.g., soda, cofee, and beer) as they tend to interfere with buccal absorption of nicotine. [2] Nicotine gum is usually recommended for 6–12 weeks, with the maximum being 6 months. After 2–3 months, the chewing time is reduced, or the gum is cut into smaller pieces, or the nicotine gum is alternated with sugar-free gum and gradually chewing is stopped completely. The disadvantage of nicotine gum is that some people do not like the taste or always feel like having something in their mouth. [3] Rapid-release gum Rapid-release gum provides nicotine faster with an increased delivery to ful fll rapid craving relief and also it avoids overdosing of nicotine. When rapid-release gum was compared with the conventional nicotine gum, fast-release gum proved rapid and more complete relief of craving. [4] Nicotine patches Nicotine patches applied directly over the skin. There is a relatively steady rate of nicotine delivery through the skin. [5]