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Combining the nicotine patch with an ad libitum type of NRT increases success rates.



Using two different forms of NRT could increase quit success by producing higher blood nicotine levels, however, the increment in success produced by combination NRTs is probably due to the use of two distinct delivery systems: one passive and one ad libitum. Use of the patch to establish a background level of nicotine, combined with using gum, inhaler/inhalator or nasal spray when cravings occur, may provide better control of withdrawal. People with lower levels of nicotine dependence may not derive additional benefit from combined therapy. There is no evidence that using more than one form is likely to lead to nicotine overdose (see Safety section).



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Stead LF, Perera R, Bullen C, Mant D, Hartmann-Boyce J, Cahill K, Lancaster T. Nicotine replacement therapy for smoking cessation. Cochrane Database of Systematic Reviews 2012, Issue 11. Art. No.: CD000146. DOI: 10.1002/14651858.CD000146.pub4.

Loh WY, Piper ME, Schlam TR, Fiore MC, Smith SS, Jorenby DE, et al. Should all smokers use combination smoking cessation pharmacotherapy? Using novel analytic methods to detect differential treatment effects over 8 weeks of pharmacotherapy. Nicotine & Tobacco Research 2012; 14: 131-41

Brose LS, West R, McDermott MS, Fidler JA, Croghan E, McEwen A. What makes for an effective stop-smoking service? Thorax 2011 66( 10) 924-6

Report of the Committee on Safety of Medicines Working Group on Nicotine Replacement Therapy. Medicine and Healthcare products Regulatory Agency Committee on Safety of Medicines, 2005.

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