We know that the combination of several of them is more effective than the use of only one of
these treatments. The association of a patch with the gums or the inhaler, forms of faster
delivery of nicotine, constitutes a good aid to smoking cessation. Le Figaro takes stock of the
advantages and disadvantages of these methods with Dr. Ivan Berlin, a
pharmacologist-addictologist at the Pitié-Salpêtrière hospital (AP-HP) in Paris.
Patches (or stamps)
The nicotine patch or patch is applied to the skin and gradually releases the nicotine through the
skin over a period of 16 or 24 hours. It should be applied to a surface of dry, hairless skin in a
different location each day. It is not recommended to smoke with a patch but it is not dangerous
to smoke in parallel if it is necessary. Removing the patch for a cigarette does not change
anything since the nicotine continues to diffuse for about two hours. In addition, the patch is now
reimbursed by social security.
Advantages:
The patch delivers nicotine more slowly than gum and tablets, but more consistently and
sustainably throughout the day. This helps relieve irritability, the urge to snack, mood swings,
difficulty concentrating, the urge to smoke and other discomforts that can occur when quitting
smoking. The patch also has the advantage of being able to be combined with other nicotine
substitutes. It is possible to wear the patch all day, while occasionally consuming nicotine
substitutes which are absorbed quickly such as gum or tablets.
Disadvantages:
The most common side effects are redness and itching where the patch is stuck. They are
generally more intense at the start of treatment and disappear within two days of removing the
patch. When worn at night, the patch can also induce changes in sleep. More rarely, other side
effects such as nausea, headaches and increased heart rate are observed.
Chewing gum
Gums should be chewed intensively and slowly for 20-30 minutes, taking breaks during which
they are not chewed at all. Nicotine, which diffuses directly through the lining of the mouth, acts
quite quickly (within 5 to 10 minutes). It is recommended to take the gummies regularly
throughout the day, or only when the urge is strong. It is possible to use another nicotine
substitute at the same time or alternately.
Advantages:
The gums quickly relieve the inconveniences associated with quitting smoking by clearly
reducing them, or even eliminating them. They help reduce or prevent weight gain after quitting
smoking.
Disadvantages:
Sleep problems may occur, especially if the gummies are taken in the evening. At the beginning
of treatment, the gums can cause irritation of the mouth, hiccups, heartburn, increased
salivation, digestive disorders, or even dental or gum problems. It is recommended that you
avoid drinking coffee or fruit juice before and while taking the gum, as these drinks reduce its
effectiveness.
Lozenges
Nicotine tablets and lozenges work on the same principle as gum but without the inconvenience
of chewing.
Advantages:
Like other nicotine substitutes, lozenges quickly relieve withdrawal symptoms and cravings
through the rapid absorption of nicotine. Tablets come in different forms. Some are quite large
and suck on each other for a long time to occupy the mouth, others, smaller, melt quickly to
relieve an urgent need.
Disadvantages:
In approximately 20% of patients treated with oral nicotine substitutes (including lozenges), side
effects are observed, which are generally mild and limited to the duration of treatment. The
majority of symptoms that appear during smoking cessation are more often related to withdrawal
than to nicotine substitutes. These are very well tolerated and their side effects are very rare.
Taking coffee or fruit juice, as with nicotine gum, reduces the effectiveness of the tablets
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