Nicotine replacement therapy (NRT), including nicotine tablets or lozenges, is a widely recognised method for aiding smoking cessation. It works by reducing withdrawal symptoms and cravings associated with quitting smoking, thereby increasing the chances of successful cessation.
Published Mar 12, 2025 | 3:00 PM ⚊ Updated Mar 12, 2025 | 3:00 PM
Synopsis: As smokers seek safer ways to quit, experts weigh in on the effectiveness of nicotine replacement therapy (NRT), its role in curbing cravings, and whether it truly paves the way to a smoke-free life.
Quitting smoking is no easy feat, and for those struggling to break free from nicotine addiction, replacement therapies like patches, gums, and tablets offer a promising alternative.
Nicotine replacement therapy (NRT), including nicotine tablets or lozenges, is a widely recognised method for aiding smoking cessation. It works by reducing withdrawal symptoms and cravings associated with quitting smoking, thereby increasing the chances of successful cessation.
However, do they really help, or are they just another way to stay hooked?
As smokers seek safer ways to quit, experts weigh in on the effectiveness of NRT, its role in curbing cravings, and whether it truly paves the way to a smoke-free life.
“Nicotine Replacement Therapy works by slowly releasing a minimal amount of nicotine to help control withdrawal symptoms associated with quitting smoking. However, it does nothing beyond that. If someone becomes dependent on NRT for too long, they may develop a reliance on it instead of quitting smoking altogether,” Senior Consultant Obstetrics & Gynaecology at Yashoda Hospital in Hyderabad Dr Sarada Vani N told South First.
“That’s why it should only be used for a specific period as prescribed by a doctor, with the primary goal always being to quit smoking entirely. It is meant to be a temporary aid, not a long-term solution,” she added.
“There are different approaches to quitting smoking. One is called ‘cold turkey,’ where a person decides that today is their last cigarette and commits to never smoking again. This method can work for many people, especially those with strong willpower. However, it may not be effective for everyone, which is why a transition period is often necessary,” said Neurologist at Hyderabad-based Apollo Hospital Dr Sudhir Kumar.
He added that nicotine patches, replacement therapies, and even e-cigarettes can help during this transition, even though they still contain some level of nicotine. While these methods can be useful in the short term, the ultimate goal should be to quit all forms of nicotine and smoking completely. Cigarettes contain not just nicotine but also many other harmful chemicals, making total cessation the best option.
“If someone consumes sugary beverages, diet soft drinks might be a slightly better option. But if they can live without diet soft drinks altogether, that would be ideal. Similarly, for someone struggling to quit smoking, nicotine replacements or medications can serve as a stepping stone, but complete abstinence is the best outcome,” Dr Kumar said.
There is also a prescription medication called Champix (varenicline), which works by blocking the pleasurable effects of nicotine. When someone taking Champix smokes a cigarette, “they don’t experience the usual ‘kick,’ which helps reduce cravings and dependence. While such medications can be useful, the key is to eventually break free from nicotine in all forms,” Dr Kumar explained.
Dr Sarada said that when it comes to pregnant women, NRT is not advisable. Pregnant women should quit smoking before planning a pregnancy, but they should not rely on nicotine replacement therapy, as it may still pose risks, including birth defects.
“Withdrawal symptoms from quitting smoking — such as body aches and discomfort — can be challenging, and NRT helps ease these symptoms so individuals can focus on quitting. The purpose of NRT is to reduce withdrawal effects, making the process mentally and physically manageable. However, it must be used only for a short period; otherwise, prolonged use becomes similar to smoking in another form,” she explained.
Some people try replacing cigarettes with candies or mints. However, this is not a scientifically proven method.
“While sugar can provide a minor ‘kick’ in the brain, its effect is significantly weaker than nicotine. Moreover, sugar itself is addictive. If someone replaces smoking with candy, they might end up addicted to both, making it a double problem rather than a solution,” said Dr Kumar.
“The key to quitting smoking is willpower. Nicotine replacement therapy (NRT) can help, but it still requires determination. The willpower to quit often comes when a person fully understands the health risks associated with smoking.”
“Many people already know smoking is harmful, but when a healthcare professional, psychologist, or counselor takes the time to explain its complications—how it affects not just health but also family life, job performance, and finances—it can have a deeper impact,” said Dr Kumar.
He added that the important thing is to support the person without shaming them.
“Smoking addiction is not a personal failure; it is a habit that developed over time, often unintentionally. The fault lies with smoking, not the individual,” he said.
He also pointed out that compared to alcohol withdrawal, cigarette withdrawal is less physically dangerous. If a heavy smoker quits abruptly, they may experience cravings, irritability, nervousness, or discomfort, but they will not suffer severe medical complications.
“On the other hand, alcohol withdrawal can lead to seizures, delirium, and even life-threatening conditions, requiring supervised medical care. This is why alcohol de-addiction often involves rehabilitation centers, while smoking cessation relies more on willpower, education, and behavioral support,” he said.
He said that ultimately, quitting smoking is both a physical and a mental challenge. Having the right motivation, support, and awareness of the risks can make a significant difference in successfully becoming smoke-free.
(Edited by Muhammed Fazil.)
