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Nicotine inhalator to stop smoking

What is a nicotine inhalator?

A nicotine inhalator, also sometimes called a nicotine inhaler, looks very much like a cigarette but is not smoked as such. It holds a cartridge containing nicotine, and it delivers a puff of nicotine vapour (in a measured dose) whenever you feel a craving to smoke a cigarette. Although an inhalator will help to reduce the withdrawal effects of stopping smoking, you will still need for willpower because it may not completely remove the desire to smoke.

How does a nicotine inhaler work?

There is little direct evidence that one nicotine replacement product is better than another,¹ but some people prefer the nicotine inhaler if they want a substitute for the act of smoking. By taking nicotine in a "clean" form through the inhalator, withdrawal symptoms are reduced, and you are twice as likely to stay free from smoking.¹

Whenever you feel the urge to have a cigarette, you can put a nicotine cartridge into the inhalator and suck hard on the mouthpiece until you can taste the nicotine. The nicotine vapour is absorbed into your mouth and throat area and helps to overcome the urge to smoke. You can keep sucking on the inhalator until there is no more taste. For most people one cartridge lasts for about 20 minutes of heavy use.

Most people find they use about six cartridges a day - the maximum recommended for any 24-hour period is 12. You may find that on cold days you have to work harder to get the same amount of nicotine vapour from the inhalator compared with warmer days.

Lastly, it is recommended that the mouthpiece is cleaned several times a week by rinsing it in water, for hygienic purposes.

How successful is the nicotine inhalator?

As with all the forms of commercially available nicotine replacement therapy, nicotine inhalators will improve your chances of stopping smoking compared to using willpower alone by almost double.² There is little direct evidence that one nicotine product is more effective than another³ and so your decision about which product to use is a personal one. Very occasionally, using a combination of two forms of nicotine replacement therapy can be more effective in heavy smokers, but this should only be tried under the supervision of a doctor.⁴

Are nicotine inhalators safe?

Nicotine inhalators are safe for most people who are trying to stop smoking. Care should be taken if you:

• are pregnant. Nicotine can affect the blood supply to the developing fetus and so may play a role in slowing the growth of the baby, resulting in a low birth weight. However, the risks of this happening with nicotine replacement therapy are less than the risks of continuing to smoke. Cigarette smoke exposes the fetus to a more intense dose of nicotine and to a number of other harmful chemicals as well.⁵ Most doctors recommend that pregnant women try other ways of stopping smoking before suggesting nicotine replacement therapy. If nicotine replacement therapy is prescribed, it may be best used on an "as required" basis rather than as a continuous therapy³
• have heart disease. Because nicotine can increase the heart rate and blood pressure, people with a history of heart attack or serious heart problems (such as angina or irregular heartbeats) should take care when using nicotine replacement therapy.⁶ Consult your doctor before using inhalators in such circumstances
• have specific medical problems. People with an overactive thyroid, diabetes, stomach ulcers and severe liver or kidney problems should discuss their condition with their doctor before starting nicotine replacement therapy²
• are under 18 years old. Nicotine replacement therapy is generally not recommended for people under the age of 18, mainly because these products have only been safety tested on adults.

Are there any side-effects?

You may experience a slightly sore mouth or gums when using the inhalator, especially if the maximum amount of cartridges are used each day.⁷ As long as you are not smoking as well as using an inhaler, the side-effects of nicotine replacement therapy are usually mild, and include nausea, muscle aches and pains, or vivid dreams.⁶

What are the benefits of nicotine inhalators?

• simple to use
• effective
• some smokers like to use a physical substitute for a cigarette when giving up
• provides a nicotine supply as and when needed.

What are the disadvantages of nicotine inhalators?

• it is a very visible method of stopping smoking
• it can cause some mouth discomfort in some people
• some smokers do not like the taste of the inhalator nicotine cartridge.

Contacts/further information

Action on Smoking and Health UK (ASH)
Tel:0800 169 0169

Quitline
Tel: 0800 00 22 00

References

1. Stead L et al. Effectiveness of interventions to help people stop smoking. Cochrane Library. BMJ; 321(5): 355-358.
2. Silagy C, Lancaster T et al. Nicotine replacement therapy for smoking cessation, Cochrane Review, Cochrane Library Issue 3, 2002.
3. Silagy C, Mant D et al. Nicotine replacement therapy for smoking cessation. In: Cochrane Collaboration. Cochrane Library Issue 3. Oxford; Update Software, 2000.
4. Hughes JR et al. Recent advances in the pharmacotherapy of smoking. JAMA 1999; 281(1): 72-76.
5. National Teratology Information Service 1997. i) Nicotine exposure during pregnancy ii) Smoking in pregnancy.
6. British National Formulary 2002. Therapeutic guidelines.
7. Manufacturers' guidelines

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