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Sizing-Up the Competition

M. D. Anderson’s guide to tobacco cessation products and treatments

November 2009

By Rachel Winters

Whether you smoke three cigarettes or three packs of cigarettes a day, kicking the habit is difficult. Over time; however, quitting smoking is the absolute most important thing you can do to improve your health. It reduces your risks for cancer and other diseases, such as heart and lung disease.

“Quitting smoking is a wonderful thing to do for yourself and your loved ones, but it can be really hard without help,” says Jennifer Irvin Vidrine, Ph.D., assistant professor in the Department of Health Disparities Research at M. D. Anderson. “I’ve worked with smart people who have such a hard time quitting that they pick a cigarette butt up off the floor when a strong craving hits!”

A great way to reduce withdrawal symptoms while you are trying to quit is to use some sort of nicotine replacement therapy. These products work by giving the body controlled doses of nicotine without the harmful chemicals that are in tobacco products, such as cigarettes, cigars and snuff.

Nicotine replacement products are sold as patches, gums, inhalers, nasal sprays or lozenges. You can purchase some of these products at your local drugstore or supermarket. But are these products right for you? If so, how do you know which one is the best?

M. D. Anderson is here to help you, or someone you care about, with this difficult yet life-saving step. It’s time to kick the tobacco habit for good.

A nicotine replacement product for every personality

“You really can’t go wrong with any of the nicotine replacement therapies,” says Damon J. Vidrine, Dr.P.H., assistant professor in the Department of Behavioral Science at M. D. Anderson. “It just depends on what works for you.”

Patches, gums and lozenges are available without a prescription. With a prescription, people also can try a nasal spray or inhaler.

“Although any of these products can be helpful, I would typically recommend trying the patch first,” Damon Vidrine says. “This is because it delivers a steady, 24-hour stream of low-dose nicotine to your system. The other products give you nicotine in isolated doses when you need it – more like cigarettes do. But, if not used correctly, they may leave you with more nicotine cravings than the patch. You can just slap the patch on and forget about it – even in the shower.”

All of these products have possible side effects, although none of them are is as bad as the effects of smoking on your body. Below, M. D. Anderson gives you some road-tested tips you won’t find on the label.

The lowdown on nicotine replacement products


Overview: As discussed above, the patch gives you a steady stream of nicotine that helps cut down on the highs and lows of withdrawal. While people on the patch are advised not to smoke, it is okay to use the patch and occasionally give in to a cigarette craving. Talk to your doctor first, but he/she will probably tell you that you will not harm yourself if you use the patch and smoke a few cigarettes. Going back to smoking is much worse for your health.

Side effects: Some people with sensitive skin can develop a skin rash when using this product. Moving it to a different spot on your body each day usually helps. 


Overview: Gum is a great way to keep your mouth busy without a cigarette. It gives you small doses of nicotine when you need it. Gum and lozenges also are good for people who are habitual about when they smoke cigarettes. Do you smoke every night after dinner? Try popping in a piece of Nicorette®. The gum now comes in flavors like “fruit chill.”

Side effects: The most common problem with the gum is that it can leave you craving tobacco more than other products. But, this is only because it is often misused. You need to chew the gum and then tuck it between your cheek and gum, and let it sit for a while. Then, you need to chew it again and repeat the process. If you don’t chew the gum as directed, your body won’t get the full dose of nicotine. 


Overview: Lozenges came onto the market after the gum. It’s for people who want to keep their mouth busy, but don’t tend to use the gum correctly. It is great for habitual smokers to indulge in while having a cup of coffee or to soothe themselves during a stressful moment. It also is for people who aren’t thrilled about the idea of having to tuck the gum between their gum and cheek to get the nicotine, as it can leave an unsightly bulge. Lozenges are as easy as sucking candy, just not quite as tasty.

Side effects: Although easier to use than the gum, the lozenge can leave a film in the mouth. It also can leave users with stale breath. 

Nasal Spray 

Overview: The nasal spray is like many sprays you might use for a runny nose or allergies. This and the inhaler are good for people who like to get a measured dose of nicotine at once. With the gum or lozenge, what you eat or drink can affect the amount of nicotine you get. The nasal spray is a single shot of nicotine when you need it. It works faster than the gum or lozenge, and unlike the patch, it can be used exactly when your craving hits.

Side effects: The nasal spray can sting the inside of your nose. Our experts say it can feel “offensive.” It also is just one shot, so if you smoke because you like the habit, this isn’t the tool for you. 


Overview: The inhaler works fast like the nasal spray and certainly faster than the gum and lozenge. Like an asthma inhaler, you put it to your mouth and breathe deeply. And like the nasal spray, the inhaler gives you a measured amountof nicotine the instant you need it. But, it isn’t quite as harsh as the nasal spray.

Side effects: The biggest trouble with the inhaler is that it is hard to use in real life. Using the inhaler in social situations can be awkward, if not alarming, for your company. It also is fairly bulky to carry around.

Reaching your goal

When you are trying to quit, don’t be afraid to rely on family, friends, medication, nicotine replacement and/or counseling.  ”To really help yourself quit, I strongly recommend a nicotine replacement product or non-nicotine medication in combination with counseling,” Jennifer Vidrine says.

Although going to see a private counselor might be impossible because of time or money, there are free smoking quit lines that have proven effective in helping smokers quit. Two are listed below.

  • American Cancer Society

       1-800-QUIT NOW

  • National Cancer Institute


“Your goal should be complete cessation,” Damon Vidrine says. “It shouldn’t be just to cut back. This can be difficult, but nicotine replacement products, non-nicotine medications, and counseling really do help people who want to quit.”

M. D. Anderson offers tobacco cessation studies to help people quit. Some of these studies offer free treatment methods. Find out if you are eligible.

Related Links

Where There’s A Will: Free Programs Help Smokers Quit (M. D. Anderson)

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Hungry for a healthier diet?

A great way to reduce withdrawal symptoms while you are trying to quit smoking is by using smoking aids. Here, a consumer review of nicotine replacement therapy. These smoking aids do not only have a full consumer review, but also the support of M. D. Anderson doctors. It’s time to kick the tobacco habit for good.

© 2014 The University of Texas MD Anderson Cancer Center