Nicotine replacement therapy (NRT), in the form of the patch or gun, is the most common smoking cessation aid, used to help relieve withdrawal symptoms and prevent smoking relapse. While there is no doubt NRT is preferable to tobacco use, it is not without long term consequences. Here are some of the potential issues.
Continued addiction is the most likely problem of using NRT to quit smoking. Nicotine is the chemical in tobacco that is physically addictive and using it in another form is still addictive. Studies have shown that the method of cutting down on tobacco use is not effective. Tobacco dependency comes from the reward system of the brain, and as the number of cigarettes each day goes down, the reward response to each cigarette increases, making that last one almost impossible to give up.
There is evidence that the drug contributes to cardiovascular disease in some ways. Nicotine is a stimulant that restricts blood vessels, chronic inflammation, oxidative injury, enhanced thrombosis, all leading to reduced oxygen delivery by red blood cells. Nicotine increases heart rate, blood pressure, and coronary vasoconstriction. Over time these can lead to heart disease, even if the nicotine is delivered from a patch or gum, instead of a cigarette.
Nicotine is generally considered not harmful in small doses. But it is used as an insecticide and is toxic to humans in large amounts; roughly 160 mg of nicotine, or 160 cigarettes at once, would kill and adult human. There is also evidence that nicotine can cause damage to a fetus. Nicotine in the blood stream of the mother can cause potential developmental problems of the brain and lung of a fetus. Again, nicotine is far less harmful in NRT from than cigarettes.
NRT is the 1st option that comes to mind to someone when they want to quit smoking. Unfortunately, the long term data on success rates with NRT is inconsistent and often very low. Some studies show smoking cessation success after 12 weeks being anywhere from 20% to as low as 5%. Often what happens is NRT keeps up the addiction, and adherence to the NRT stops, or the products become to expensive or inconvenient to use, and so eventually it is easier just to slip back into smoking. NRT also does not do anything to treat the behavioral dependencies to smoking.
Complete smoking cessation following short-term use of NRT is conceptually safer than is long-term NRT use to maintain abstinence. Optimal treatment should include behavioral treatment, trigger avoidance, substitution of habits, and coping mechanisms. According to research from Rutgers University, presented at SRNT, combination therapy is best for long term success, and many smokers are unaware of the other potential options for treating behavioral dependency.