Quitting smoking: How much do nicotine patches and gum help?

Nicotine replacement products increase the chances that a heavy smoker will be able to quit smoking, but more than one attempt will usually be needed.

There are many advantages to quitting smoking, but it is no easy task. The first week can be particularly difficult. People reach for a cigarette again mostly because their body is craving nicotine. This can make people easily irritated, aggressive, anxious or depressed.

Nicotine replacement therapy (NRT) aims to reduce these withdrawal symptoms. You can buy these products in chemists without a prescription in Germany and other countries. In Germany, nicotine gum, lozenges and patches are available. However regulations prevent statutory health insurers from covering the costs of quit smoking medications. In other countries you can also get nasal sprays and inhalers. You can read about NRT in more detail in our Fact Sheet.

To weigh up the advantages and disadvantages of NRT, researchers from the Cochrane Collaboration looked for trials that tested nicotine products. They systematically evaluated more than 130 trials involving more than 40,000 smokers. Their conclusion: NRT can help smokers quit. This was shown for smokers who smoked more than 15 cigarettes a day.

In the trials, all the different types of NRT were helpful. The majority of smokers were not able to quit though. Out of 100 smokers who did not use any nicotine product, only 10 were able to quit (10%). Out of 100 smokers who used a nicotine product, about 17 were managing without cigarettes 6 months later (17%). Some of the people who kept on smoking were able to reduce the number of cigarettes they smoked a day.

Whether or not NRT works does not seem to depend on whether or not there is additional support at the same time. Heavier smokers who used nicotine gum were more likely to quit if they used the higher dose of gum. For nicotine patches, an 8-week course appears to be enough. Using them for longer did not improve the chances of quitting. Using patches for 16 hours appears to be as effective as using them 24 hours a day.

Most people can tolerate NRT well. Nose sprays can irritate the membranes inside the nose, particularly if people have sinusitis or a runny nose. Nicotine patches can cause skin irritation or rashes where they are applied. Chewing gum can sometimes cause aches in the jaw or stomach problems.

© IQWiG (Institute for Quality and Efficiency in Health Care)