Nicotine addiction explained
Nicotine is highly addictive. When you puff on a cigarette, it takes just seconds for the nicotine in the cigarette to go from the lungs to the brain.
If someone has smoked for a while, their brain is filled with receptors that eagerly await incoming nicotine. Think of nicotine as a key, and receptors as little locks. When the nicotine unlocks the receptor, a feel-good chemical called dopamine is released, giving the person a little hit or buzz. This doesn’t last long. The nicotine soon fades making the receptor eager for more. Cue a craving! The cycle begins again.
People who are addicted to nicotine may get feelings of withdrawal when they quit. These include:
- Urges or cravings to smoke
- Finding it harder to concentrate or feeling restless
- Trouble sleeping
- Being easily upset, feeling irritable, frustrated, angry
- Being anxious or feeling down
- Increase in hunger or weight gain.
Feelings of withdrawal usually only last a few weeks.
Nicotine replacement therapy (NRT)
Nicotine replacement therapy (NRT) helps to reduce feelings of withdrawal in people who smoke. NRT gives a little bit of nicotine, which locks on to some of the receptors in your brain, lessening cravings and feelings of withdrawal. This means you can focus on addressing your other triggers, like smoking with your morning coffee or smoking when stressed.
Get support from AQL
Nicotine addiction is one part of why you smoke. There can also be habitual parts, like smoking in social situations, or with coffee or alcohol. Others are psychological or emotional - smoking to cope with stress or anxiety. That’s why yarning with an AQL counsellor can help. Yarning with AQL helps you manage the habitual or emotional parts of why you smoke. AQL counsellors can also support you if you're using vapes to quit the smokes.
Types of nicotine replacement
There are 5 types of NRT - nicotine patches, gum, lozenges, mouth spray, and inhalator. Nicotine patches are slower-acting, and the other types are faster-acting.
Most people find it’s best to use a combination of slower- and faster-acting types, like the patches plus gum and mouth spray. That way you have a steady level of nicotine for the day plus a bit extra at times when you would normally smoke.
It’s important to speak with your doctor, Aboriginal health worker, TIS worker or AQL about which NRT is best for you, and how best to use it. Your doctor or pharmacist will be able to talk to you about what dosage is right for you.
Slower-acting NRT
Nicotine patches
The slower-acting nicotine patches give you a steady level of nicotine over a longer period.
You apply the nicotine patch to your skin, much like you would a band-aid, usually in the morning. The nicotine in the patch is slowly absorbed into your body through your skin.
Read more about using the nicotine patch
Step 1: Press the patch onto a dry hairless area of skin for about 20 seconds. You can put it on your chest, arm, or back. Use a different area of your skin each day. If you applied the patch correctly, you can shower, bathe, or swim without worrying about it coming off. It’s important to apply the patch to different areas of skin day-to-day to avoid skin irritation.
Step 2: Rinse your hands with water.
It can take a little while for the patch to start working, so use a faster-acting type of NRT (nicotine gum, mouth spray, lozenge, or inhalator) to help reduce cravings.
Faster-acting NRT: use in combination with slower-acting
The faster-acting gum, lozenges, mouth spray and inhalator give you nicotine more quickly than the patches. You use them when you have a craving, or you know a craving will come on.
Nicotine gum
Nicotine gum looks like regular gum, but you don’t use it in the same way you would use normal chewing gum. You use the ‘park and chew’ method.
Read more about using nicotine gum
Step 1: Pop the gum into your mouth and start chewing. When you feel a tingling sensation, park the gum under the tongue or between your gum and cheek. Park it until the tingling stops and then start chewing again.
Step 2: Repeat. Park and chew the gum for up to 30 minutes or until the flavour is gone and the urge to smoke has eased. Then, throw the gum away.
Nicotine lozenges
Unlike other lozenges, you don't chew, suck or swallow the nicotine lozenge. Nicotine is absorbed through your mouth and slowly released into your body, so using a nicotine lozenge is all about adopting the ‘roll technique' (or the 'cheek to cheek' technique as it’s also known).
Read how to use nicotine lozenges
Pop the lozenge in your mouth between the gum and the cheek and roll it around your mouth from time to time until it dissolves completely. This should take around 15 to 20 minutes. Do not chew, suck, or swallow the lozenge.
Some types of acidic drinks like coffee, fruit juice, soft drinks or beer can affect how well the lozenge works. Wait for 15 minutes after having these drinks before using the lozenge. The lozenge also won’t work as well if you take it while eating or drinking.
Nicotine mouth spray
The nicotine mouth spray is sprayed onto the inside of your mouth, but you don't use it like a breath freshener. You want to absorb the nicotine through the lining of your mouth, not swallow it. It's all about placement.
Read more about using nicotine mouth spray
Bring the nicotine mouth spray close and open your mouth, then aim it either into the side of your mouth, or under your tongue. Now press down on the nozzle. Do not swallow for a few seconds after spraying for best results.
Nicotine inhalator
The nicotine inhalator may look like a cigarette, but you need to use it differently. Take short, shallow, and frequent puffs of the inhalator, like sipping a straw. You need to take about eight to 10 times as many puffs on the inhalator as you would for a cigarette, so that's about 60 to 80 puffs.
What about prescribed stop smoking tablets?
If you visit your doctor, you can get a prescription for stop smoking tablets. These tablets can help to reduce feelings of nicotine withdrawal. Your doctor will advise if these are suitable for you.
What about using e-cigarettes to quit the smokes?
Some people who smoke use e-cigarettes through a prescription from their doctor, for a short period of time, to help them quit the smokes. Your doctor will be able to talk with you about whether this is the right option for you.
Access NRT through Closing the Gap
You can buy NRT from most pharmacies, supermarkets or online. You can also get discounted nicotine patches on the Pharmaceutical Benefits Scheme (PBS). You need to get a prescription from your doctor, which you take to your pharmacist.
Under the Closing the Gap Scheme, eligible Aboriginal and Torres Strait Islander people can access nicotine patches for free or for a small co-payment. Speak with your doctor, Aboriginal health worker or TIS worker, or call AQL on 13 7848 for more information.
Quitting Questions
Is NRT safe?
The different types of NRT pass strict safety standards set by the Therapeutic Goods Administration (TGA) before they can be sold in Australia. NRT is safe to use for most people, but some types of NRT may be preferred over others in some situations. It’s best to speak to your doctor or pharmacist before starting NRT, so they can help you work out which types will suit you best.
Can I use NRT if I’m pregnant or breastfeeding?
Congratulations on your pregnancy and for deciding to stop smoking! It’s the best thing you can do for baby and you. AQL can help you through your quitting journey while pregnant or breastfeeding. If you’re having trouble quitting the smokes with AQL alone, using NRT is an option but it’s important to discuss the risks and benefits with your doctor, Aboriginal maternal health worker, or pharmacist. Not all types of NRT are suitable when pregnant.
Can I get addicted to NRT?
Most people stop using NRT when they feel they no longer need it. The amount of nicotine in NRT is lower compared to smokes. It also takes longer for nicotine to get to the brain and to give you a nicotine hit. This means it’s much easier to stop using NRT than it is to stop smoking.
What happens if I have a smoke while wearing a patch?
You don’t need to take the patch off if you slip-up and have a smoke. It’s best to leave it on. Slip-ups – a puff or a smoke during a quit attempt – are common. It doesn't mean you should stop trying to quit! It might be a sign you aren’t using enough NRT. For example, you might need to increase how often you are using the faster-acting types of NRT. It’s best to speak with your doctor or pharmacist to help you work out what dose and frequency of NRT you should be using to prevent slip-ups.
Please note, this information is for general use only. Please consult your health professional for further advice.
If you would like to provide feedback, please contact quit@cancervic.org.au
Last updated February 2024