Guide to the nicotine nasal spray including possible side effects and how it works.

nicotine nasal spray
What is nicotine nasal spray?
The nicotine nasal spray is the strongest form of nicotine replacement therapy, which is particularly useful and effective for highly dependent heavy smokers who cannot give up by any other means.

The reason that the nasal spray is so much more effective is because of its fast action. Once the nicotine has been administered, it enters the bloodstream and reaches the brain within 10 minutes. Other methods take much longer. This method also most realistically mimics the fast "hit" obtained when smoking a cigarette. This makes it much easier to control and satisfy cravings if they suddenly arise.

The nicotine comes in the form of a solution that is contained in a spray pump and is administered into the nostrils.

How does nicotine nasal spray work?

One dose with this form of NRT is two sprays, one into each nostril. Each spray is the equivalent of 0.5 mg of nicotine; so one spray into each nostril gives a total amount of 1 mg of nicotine, which is about the same amount of nicotine received upon smoking one cigarette. As the nicotine is administered into each nostril, it is inhaled and rapidly absorbed into the bloodstream through the lining of the nose. This is the fastest way that nicotine can enter the bloodstream.

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As the nicotine reaches the brain, the user receives a nicotine "rush" that is very similar to the rush obtained from smoking a cigarette.

Doctors recommend that to be highly effective the nicotine spray should be administered once or twice each hour but no more than five times in one hour and no more than 40 doses a day.

Treatment with the nicotine nasal spray should be followed for about 12 weeks. Many people who use NRT's and fail, do so because they do not follow the treatment for the full duration.

For the first 8 weeks, users of the nicotine nasal spray should administer 1 - 2 doses each hour. For the next two weeks, the total amount of doses per day should be halved and over the final two weeks the number of sprays should gradually be reduced until by the end of the 12th week the use of the spray is minimal and the ex-smoker is ready to stop all treatment.

If you are not ready to stop using the spray after 12 weeks, don't worry. You can continue to use it until you are ready to stop, but only for a further three months. If you cannot stop by this time, you should consult your doctor. The nicotine nasal spray should not be used for longer than six months.

What is the success rate?

Researchers have found that the nicotine nasal spray is the most effective form of NRT, especially in the cases of heavy smokers. It has proved to be successful when other forms have failed.

During a controlled study, results showed that nearly 55% of smokers who used the nasal spray, had still abstained from smoking six weeks later. This was compared to only 27% who were given the placebo nasal spray.

A year on and 25% of the first group were still not smoking compared to 13% of those in the second group. All smokers received professional counselling during the experiment.

Many studies have shown that smokers are twice as likely to quit smoking if they use a form of nicotine replacement therapy and the success rate increases if coupled with professional support and counselling.

Is this method safe?

If you choose to use the nicotine nasal spray, care must be taken to follow the instructions and adhere to the correct dosage.

Although the nasal spray may be the most effective form of NRT, it also has the greatest number of side effects.

As this form of treatment is the most comparable to smoking, there is also a greater likelihood that a user will become addicted to the nasal spray over a period of time. Some studies show that up to 20% of users continue to administer the spray for longer than six months and even up to a year.

If you have any specific medical conditions, especially any of those mentioned below, it is best to advise and consult your doctor before using this type of medication.
  • Nasal or sinus irritations or allergies
  • Asthma
  • Heart disease
  • Cardiovascular or circulatory disease
  • Liver disease
  • High blood pressure
  • An overactive thyroid
  • Stomach ulcer
  • Diabetes
  • Pregnancy
Care should also be taken when administering the spray. You should avoid any contact with the eyes, mouth, ears and skin and wash any affected area immediately with water.

Are there any side effects?

Many users of the nicotine nasal spray have reported a number of side effects. In fact, some studies show that up to 75% of nasal spray users experienced some form of side effects after taking the medicine.

As with all types of NRT, there are mild side effects and more severe ones. The milder side effects tend to be temporary and subside as the use of the nasal spray continues. This may take between a week to two weeks.

Mild and common side effects that should soon subside are:
  • Watery eyes
  • Irritation of the nose and throat
  • Cough
  • Nose bleeds
  • Sneezing
  • Diarrhoea
  • Palpitations
  • Headaches
  • Hot and peppery feeling in the back of the nose and throat
  • Stomach pain
  • Flatulence
More serious side effects that could occur and if they do, a doctor should be seen, are:
  • Pains in joints and muscles
  • Tightness of the chest
  • Shortness of breath
  • A tingling sensation in the limbs and extremities
  • Confusion
  • Irregular heartbeat
  • Swelling of the legs or feet
You know that you have overdosed on the nicotine if you have any of the following:
  • Cold sweats
  • Seizures
  • Dizziness or fainting
  • Vomiting
  • Abnormal changes in your vision or hearing
  • Shaking
  • A constant feeling of tiredness

What are the advantages of using this method?

  • The fast hit of nicotine helps to control the cravings quicker and more effectively.
  • The dose is controlled rather than a steady supply.
  • It is possibly the most effective form of NRT.
  • It has proved successful with high nicotine dependency smokers.

Are there any disadvantages?

  • More people have reported side effects with the nasal spray than with any other form of NRT.
  • It can be quite inconvenient having to carry a nasal spray around.
  • It is not very discreet to use.
  • It is more addictive than the other forms of NRT.
  • The side effects may be uncomfortable and difficult to ignore.
  • In heavy smokers, it may be difficult to control the number of doses taken.
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