How to use NRT

Combination NRT is recommended in pregnancy - this means using a patch plus a fast-acting nicotine replacement product. You should aim to take as much NRT as you need, as regularly as you need it, to prevent you from smoking – there’s no need to worry about taking too much.

How much NRT to take and how often?

Your NHS Stop Smoking Practitioner will have offered you combination NRT - daily NRT patches plus a fast-acting NRT type, such as lozenges, an inhalator or spray. Because nicotine is removed from your body twice as quickly when you're pregnant, combination NRT works better and is recommended to pregnant women. The NRT patch will give you a steady supply of nicotine and - when you need extra help - you can ‘top up’ your nicotine with a fast-acting NRT product.
Your Stop Smoking Practitioner will work out the right strength of NRT for you and tell you how often to use your lozenges, inhalator or spray. He or she will have the most up-to-date information and is best qualified to support you. On this page we’ve put some general usage information and tips to help you get the most from your NRT:
Try using your lozenges, inhalator or spray more often if the urges to smoke are very strong or if you’re troubled by withdrawal symptoms. You don’t need to worry about overdosing so don’t try to minimise the amount of NRT you take – it’s much more important that you use enough to prevent you from smoking at all. Using less NRT than advised may not help you to quit.
It is standard practice to include cautionary statements about use within medication leaflets. Your Stop Smoking Practitioner will have the most up to date information about NRT use and dosage in pregnancy.

When to start, when to stop?

NRT is designed to be used from your quit date. If using combination NRT, it's best if both products are started together rather than trying to manage on just the patch or just a fast-acting NRT.
You can use NRT for as long as you need in pregnancy, and even for the whole of pregnancy and beyond. Your Stop Smoking Practitioner will work with you to gradually reduce your NRT until you do not need it at all. Don't stop sooner than than they advise you to or start reducing your NRT on your own, even if you feel like you no longer have cravings to smoke - if you stop using NRT too early you're more likely to start smoking again.
If you have a slip up and smoke, don't panic or stop using your NRT - see our page on 'Slips and relapse' to find out what to do.

What NRT products are available and how do I use them?

NRT is available in different strengths and types depending on how much you were smoking before you were pregnant and your personal preferences. As part of Baby, Me & NRT, we provide patches plus either lozenges, an inhalator or spray:

Description of NRT products
Product	Description
Patch	A nicotine patch is worn on the skin. It works by slowly releasing nicotine through the skin to replace some of the nicotine you’d normally get from smoking. The nicotine patch: available in 16-hour (25mg, 15mg) and 24-hour (14mg) strengths as part of Baby, Me & NRT. Use one nicotine patch per day (re-apply or replace if the patch comes off). Apply on waking up to clean, dry skin with minimal hair and fat, such as your arm or upper body. Avoid sensitive areas of skin, and any skin that is sore or broken. Hold the patch in place for 10–20 seconds to make sure that it sticks properly. Choose a different part of your skin each day to avoid irritation.
Inhalator	Nicotine cartridges are inserted into a plastic holder with a mouthpiece. Nicotine is absorbed into your bloodstream through the lining of your mouth as you inhale. The inhalator is available as a 15mg cartridge as part of Baby, Me & NRT. Insert the cartridge into the device and draw in air through the mouthpiece to release nicotine. Draw and hold in the mouth. Imagine sipping gently from a straw and holding in liquid in your mouth. The amount of nicotine from one puff of the cartridge is less than that from one puff of a cigarette, therefore you need to inhale more often than when smoking a cigarette. A single 15 mg cartridge will last for approximately 40 minutes of intense use. Throw cartridges away after 90 minutes (the vapour will have gone). The inhalator can be used as required when a craving occurs, or used before a craving to prevent it.
Lozenges	Nicotine lozenges release nicotine as they slowly dissolve in the mouth. The nicotine goes through the mouth’s lining and into your bloodstream. These may suit you best if you don't want to be reminded of the action of smoking. Lozenges are available in 2mg and 4mg strengths as part of Baby, Me & NRT. Coffee and fruit juice can decrease the amount of nicotine that goes through the mouth lining, so you should avoid these for 15 minutes before the using NRT lozenges. Place the nicotine lozenge in your mouth and allow it to dissolve slowly. Do not chew or swallow. Do not eat or drink while the lozenge is in your mouth. 1 lozenge should be used every 1-2 hours, as required. Only use 1 lozenge at a time
Mouth spray	Nicotine mouth spray allows nicotine to be absorbed into the bloodstream through the inside lining of your mouth. If you are using the mouth spray for the first time you must prime the spray pump. Press the top of the bottle with your index finger three times until a fine spray appears. Point the spray nozzle towards your open mouth and hold it as close to your mouth as possible. Press the top of the dispenser to release one spray into your mouth, aiming for the inside of the cheeks. Do not inhale while spraying to avoid getting spray down your throat. For best results do not swallow for a few minutes. If your cravings do not disappear with one spray, use a second one.

Please watch our video on how to use the different NRT products. To skip to a specific product, click on the three line in the top left corner. For subtitles, press the 'CC' icon on the bottom right.

For more practical usage tips from pregnant women and Stop Smoking Practitioners, see 'Tips for using NRT'.

For best results, always use as instructed!

For NRT to help you quit smoking, evidence shows that it’s really important to stick to your schedule for when and how to use it, as agreed with your Stop Smoking Practitioner . Like other medications, NRT works best if you take the recommended amount each day and keep using it until the full course of treatment is finished. Skipping days or stopping treatment early makes it harder to remain a non-smoker - and NRT can only help you if you use enough of it.

The first few days of using NRT to stop smoking are crucial. People who stick to their NRT routine in the first few days are more likely to succeed at quitting smoking. So, try hard to get a routine fixed in those first few days of using NRT. Using it on a regular basis will get you into a habit, making it easier.

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I’ve managed two weeks now without a single cigarette and I feel fine – I think I’ll try going without my NRT from here on.

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If all is going well with your quit attempt, that’s brilliant and you should be proud of yourself. But don’t be tempted to test whether you can cope without NRT too soon - this can be a common cause of starting to smoke again. It’s really important to use NRT for the length of time you agreed with your Stop Smoking Practitioner. He or she will gradually lower the dose until you’re off it completely. Remember - you can’t easily tell when NRT is working. Don’t stop it because you no longer have urges to smoke – this means that NRT is working and helping you to quit.

Don’t get caught short

You may experience many situations that make you want to smoke, so it’s important to always have a fast-acting NRT product with you when out and about e.g. by keeping a supply in your handbag.
Check how much NRT you have left so that you don’t run out of it. And speak with your Stop Smoking Practitioner when your supplies are getting low. Don’t let yourself run out of NRT!

Baby, Me & NRT