The Problem with Nicotine Replacement Therapy

The debate over the viability of nicotine replacement therapy continues to amble on. A report by the Medical University of Vienna highlights that the main problem with nicotine replacement therapies is that they can be more damaging than helpful. With tobacco usage continuing to be a global health care issue, researchers have begun taking far deeper looks into the benefits or detriments involved in using nicotine replacement therapy.

What is Nicotine Replacement Therapy?

Nicotine replacement therapy, or NRT, is carried out in a variety of methods. Usually the method chosen for any individual is done so due to personal tastes of the patient or a personal preference for the treating physician. Currently, NRT includes:

  • Gum
  • Nasal spray
  • Patch
  • Lozenges
  • Inhalers

While cigarette smoking is notably addictive due to the repeated delivery of bolus doses of it to the bloodstream, repeated exposure to nicotine also causes neuro-adaptation that actually results in nicotine dependence. Since smoking cessation still produces significant health results, using NRT options seems the ‘healthier’ option. But is it?

Is NRT a Viable Option?

The evidence that proves nicotine is the addictive component of tobacco usage is the basis for the rationale that NRT can be a great transitional therapy on the way to full smoking cessation and then onto therapies to treat the nicotine addiction itself. However, other supported research and studies also share that NRT may not be a great option and for good reasons. What are those reasons?


One concern relating to NRT’s is that people may actually become addicted to the NRT itself. This is undeniably true. Many who have utilized patches or gums will openly share that they simply traded one addiction for another. No one can really doubt that as fact, considering that the NRT is really only there to rid the patient of the habit of the act of smoking itself. While some patients will certainly require this draw down method, others may be better served by using other options that help with smoking cessation and nicotine addiction simultaneously.

The problem with trading this particular addiction for another product is that the cost of those NRT products can often top, miserably so, the cost of actually smoking. Certainly dependant on the amount a particular smoker uses on a daily basis, for some, the price of smoking cigarettes is just cheaper, and many who determine that will go back to them quickly once they realize they aren’t shaking off a habit, just using a different method of delivery.


Full evaluations of how NRT’s work in real world studies have produces far more modest outcomes when it comes to industry-funded research. As different nations handle the issue of public health in relation to smoking and cessation, some portions of world populations will find themselves completely exempt from any type of public programs to help. This exemption itself makes it almost impossible to hold science down to complete accuracy.

In 2002, Pierce and Gilpin determined through a real-world effectiveness study that, ” Since becoming available over the counter, NRT appears no longer effective in increasing long-term successful cessation.” Quit rates with NRT’s also drop dramatically between four weeks of therapy and one year. A smoking cessation rate at four weeks of 53% fell to a meager 15% quit rate at one year of NRT.

Associated Health Risks

One of the main reasons cited for utilizing NRT’s in aims of gaining full smoking cessation and freedom from nicotine addiction is for health benefits. Unfortunately, NRT’s are not without their own set of health risks. They can cause diseases of the circulatory system, the retina and kidneys, they can

decrease the extensibility of arties, and even have been associated with duodenal and stomach complaints. The nicotine itself, without going through the lungs, is still a cause of cancer. While it was once touted as being non-carcinogenic, it has since been proven that it leads to an increase in tumor cells and can slow the rate at which they die off.

Another issue that comes under the element of associated health risks is the side effects patients have suffered utilizing NRT’s. While side effects with NRT are just as effected by issues such as the dose of nicotine, brand of patch or gum, or any particular allergies the patient suffers, there are still some common side effects that may send a patient dedicated to their own NRT therapy, running back to the old smokes. Some of the most commonly reported side effects of some NRT’s are:

Image c/o:

Image c/o:

  • Dizziness
  • Skin Irritation (Patches)
  • Racing Heartbeat
  • Headaches
  • Nausea
  • Sleep disturbances
  • Muscle Aches or Stiffness
  • Mouth Sores (Gum)
  • Bad Taste

The management, repeat visits and side effects associated with NRT’s often ends up causing the patient further exasperation when their medical costs increase exponentially until the point that smoking becomes the frustratingly cheaper option.

Lack of Science

There is no doubt as well that a good portion of the population that approaches the task of smoking cessation are a bit taken aback by the lack of solid science to support the benefits of NRT’s as a helpful therapy. Citizens of the world have learned that new medications and methods released before any real viable studies are concluded have historically lead to even bigger issues that end up as class action lawsuits plastered all over our televisions. The base fear isn’t unfounded.

Do NRT’s Free Smokers from Addiction?

The most supported studies seem to say no. In many cases, nicotine replacement therapies only seem to cause the patient to switch from one addiction to another. In many of those cases, patients tend to find that the NRT’s themselves come at a higher cost, come with their own set of risks and side effects, and come in forms that also aren’t always convenient in their usual locations. Unfortunately, in many cases as well, patients who aren’t finding the relief they sought in those NRT methods, also smoke on top of them, against all evident advice, and cause themselves a more untimely death than smoking or the NRT’s alone ever would have.


  1. What does “comment is awaiting moderation” mean? My comment seems to be frozen. Should I do anything else?

    By the way, thank you for publishing my email address.

  2. A systematic review listed chest pain aswell, but not the reason for this symptom. 12 months not smoking, still using gum, I have this symptom occasionally. Any thoughts?

  3. does anyone have any interest in perhaps bringing suit against Glaxo-kline for Nicorette use or against equate for their brand of nicotine gum? used these for approx. 10 years. much expensive dental work has now been ruined. I have lost several teeth due to chewing this gum!! it is unknown to the “average Joe” how addicting these products can be. I am unsure at this time what I will do with the tooth loss issue. have more teeth (capped) that are at risk. I found that I must have the gum in order to stay away from smoking.

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