Combination NRT

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Improve your patient's chance of quitting

 

A combination of NRT is 27% more effective than using a patch alone1

 

Why Combination NRT?

  • NRT has been shown to be an effective pharmacotherapy2
  • It provides a temporary substitute for the nicotine that smokers receive from cigarettes and delivers nicotine without the other harmful toxins that are found in tobacco2,3
  • The use of NRT aims to assist smokers who want to quit by helping to relieve the urge to smoke along with nicotine withdrawal symptoms, such as irritability, low mood and restlessness2,4
  • Absorption of nicotine from NRT is either mucosal (oral and nasal formats) or transdermal (patch)5
  • While transferred nicotine dependence from cigarettes to NRT is rare, it is both less harmful and easier to break than smoking dependence3,6

 

What is the benefit of combination NRT?

  • Combination NRT has been shown to be more effective than the use of a single NRT product1
  • Combination NRT is the use of a nicotine patch, which provides a steady supply of nicotine, along with a fast-acting flexible format to help with immediate cravings1,3
  • The safety profile of combination NRT is comparable to monotherapy7,8 and even with combination NRT, the levels of nicotine received are unlikely to be higher than those received from smoking9
  • Data from a Cochrane review showed that compared with the use of a single NRT product, combination NRT can increase long-term quit rates by 27%.1

 

Combination NRT is recognised by NICE and NCSCT and is recommended  for smokers who want to quit3,9

NCST, National Centre for Smoking Cessation and Training; NICE, National Institute for Health and Care Excellence; NRT, nicotine replacement therapy. 

 

Example Scenarios

Case 1: Tony

Tony wants some advice.  He has been smoking for 10 years, and tried to give up once before, about three years ago.  He managed to stop for a couple of months using nicotine patches but started again when he started socialising more often with friends who smoked. He found dealing with the cravings really difficult.  His wife is expecting and he wants to stop for good.  He smokes around 15-20 a day, and finds cravings more an early morning cigarette the hardest to manage.

 

 

Case 2: Raminder

Raminder is determined to give up smoking, but finds it difficult to break the habit.  She smokes socially when out with friends, and no more than 6 to 8 a day.  She enjoys the social aspect and is worried about putting on weight if she stops.  What product and advice is most appropriate?

 

 

Click here for NICORETTE® (nicotine) product information.

 

References

1. Theodoulou A et al. Cochrane Database of Systematic Reviews 2023, Issue 6. Art. No.: CD013308. DOI: 10.1002/14651858.CD013308.pub2 
2, Hartmann-Boyce J et al. Cochrane Database Syst Rev 2018;5:CD000146.
3. NICE guideline NG209. Tobacco: preventing uptake, promoting quitting and treating dependence. Aug 2022. Available https://www.nice.org.uk/guidance/ng209. Accessed: Nov 2022.      4. West R and Shiffman S. Psychopharmacology 2001;155:115–122.
5. Wadgave U and Nagesh L. Int J Health Sci (Qassim) 2016;10(3):425–435.
6. Nicorette Invisi 25 mg Patch Summary of Product Characteristics.
    Available at https://medicines.org.uk/emc. Accessed: December 2022.
7. Cahill K et al. Cochrane Database Syst Rev 2013;5:CD009329.
8. Kornitzer M et al. Prev Med 1995;24:41–47.
9 National Centre for Smoking Cessation and Training (NCSCT). Briefing: 3. Combination nicotine replacement therapy 2012.
   Available at: https://www.ncsct.co.uk/usr/pub/Briefing%203.pdf  Accessed: December 2022.                                                                                       
10. Nicorette Inhalator Summary of Product Characteristics.  Available at https://medicines.org.uk/emc. Accessed: December 2022.

 

Date of preparation: September 2023

UK-ACA-2300435