There are five forms of nicotine replacement therapy you can choose from: 

--Nicotine Patch (over-the-counter):

The patch delivers a steady amount of nicotine through the skin when it is worn over a 16 or 24-hour period.  Patches come in three dosage strengths (21 mg, 14 mg and 7 mg).  A nicotine cessation specialist or health care provider can help you decide what dose you should start with based on how much you smoke or chew.  After 2-6 weeks you will step down a dose, and you will continue stepping down until you no longer need the nicotine anymore.

Pros:  Requires only once a day use.  Small size.  Easily concealable.

Cons:  Releases nicotine more slowly than other medications.  Can cause skin irritation and sleep problems. 

The nicotine in the gum is absorbed through the lining of your mouth.  For maximum benefit, you should not drink, eat or chew anything else at least 15 minutes before you chew the gum or while it’s in your mouth.  You chew nicotine gum differently than you chew other gum.  You only chew it for a few minutes.  When you notice a peppery taste or slight tingling sensation, stop chewing it and hold the gum between or cheek and gum.  When the tingling taste is gone, chew the gum again.  Again, talk to a nicotine cessation specialist or health care professional in order to determine how many pieces of gum you should chew each day and at what intervals. 

Pros:  May satisfy oral craving.  Comes in several flavors including mint and orange.  Delays weight gain.  Readily available when cravings hit.

Cons:  May cause indigestion or make your jaw hurt.  

Similar to the gum, but you suck on the lozenge like you would a piece of hard candy.  The lozenge gives you a dose of nicotine through the lining of your mouth.  For maximum benefit, you should not eat or drink anything for 15 minutes before or after you put a lozenge in your mouth.  It will take 20-30 minutes to dissolve.  Do not bite, chew or swallow it.  Again, talk to a nicotine cessation specialist or health care professional in order to determine how many lozenges you should be using per day and at what intervals, which is based on how much tobacco you were using prior to quitting and the severity of your nicotine addiction.

Pros:  May satisfy oral craving.  Comes in two dosage strengths.  Flavored mint or cherry.  Readily available when cravings hit.

Cons:  May cause heartburn, upset stomach or hiccups. 

Nicotine inhalers are about the size and shape of a cigarette.  They contain a nicotine-filled cartridge that gives you a “puff” of nicotine which is absorbed through the lining of your mouth.  Each inhaler puff has about one-tenth the nicotine of a cigarette puff, so it can take 6-16 cartridges a day to help you get through the beginning stages of quitting. 

Pros:  Satisfies the physical craving for nicotine and the psychological need to hold a cigarette.  Acts more quickly than nicotine gum.  Relatively easy to use.

Cons:  More expensive than gum or lozenges.  Requires more frequent use.  May cause dependence.  Can cause mouth or throat irritation, coughing, nausea, hiccups and/or headache.

One spray in each nostril delivers a dose of nicotine through the lining of your nose.  Depending on your nicotine addiction, you may need 8-40 sprays per day.

Pros:  Delivers nicotine more quickly than the inhaler, gum or lozenge.  Is readily available when cravings hit. 

Cons:  May cause dependence.  Causes hot peppery sensation in nose/throat.  Also sneezing, coughing, inflammation of the nasal passages, hiccups and/or headache.  Side-effects may take a week to get used to.

There are two Non-Nicotine prescription medications that are currently used to help people quit using tobacco.  Only a doctor or other health care provider can prescribe these medications.

This is an antidepressant medication that helps you cope with cigarette or dip cravings by stimulating the release of the same chemicals in your brain that nicotine does.  This medication may be more beneficial in patients who also suffering from mild underlying depression.  You start using this medication two weeks before your scheduled quit date.  After two weeks of being on the medication, you should stop using tobacco altogether.  You may use this medication in conjunction with nicotine replacement therapy (i.e. the patch, gum, lozenges, etc.)  You should use this medication for at least 8-12 weeks. 

Pros:  Easy to use.  Safer to use in pregnancy.  Can be used in combination with nicotine replacement therapy.

Cons:  You have a risk of 1 in 1000 of experiencing a seizer on this medication.  May also cause dry mouth, insomnia, nervousness, difficulty concentrating, rash and/or constipation.

A prescription medication that works by blocking the nicotine receptors in your brain.   In doing so, there is no longer any fun or pleasure in smoking.  Tobacco users often feel a sense of calm and relief when they light up or put in a dip, but with Chantix, they will no longer feel these sensations, so cigarettes and dip are no longer of any use to them.  Chantix also lessens withdrawal symptoms. 

Pros:  Anecdotally, this medication has seemed to help many people quit. 

Cons:  May cause nausea, changes in dreaming, constipation, gas and/or vomiting.  It may not work as well for those who smoke more than one pack per day and have been smoking for a very long time.  Since Chantix is so new, there have been no long-term studies done on it yet.