Is there really any difference in effectiveness between all the different nicotine replacement medications?
A. Yes there are some differences in effectiveness and side effects. The Nicotine patch, gum and Nicotrol Nasal spray all give about double the success rate (about 20% per year) compared with not using them (placebo = 10% quit rate). Actually, the Nicotrol oral inhaler, although showing a trend toward better quit rates at 1 year, did not show a significant difference compared with placebo. Also, the Nicotrol Nasal and oral inhaler can flare up Asthma or Emphysema, therefore, I try to avoid these meds in such patients. Also, there is a higher addiction potential with the Nasal spray, oral inhaler, and even with the nicotine gum compared with the patch. In general, my preference is the Nicotine patch, then the gum, then the nasal inhaler, and last, the oral inhaler. Of course, the choice must be individualized, and guidance by your doctor is advised.
