You may need to use more NRT. Make sure you are taking enough NRT and not smoking any cigarettes (smoking prolongs your withdrawal symptoms). If you are already taking enough NRT and are still struggling, try our tips below and please speak to your Stop Smoking Practitioner.

These symptoms usually settle with time / continued use. Make sure you are using the product correctly (see 'Tips for using NRT') and try our tips below. If symptoms are difficult to put up with, please speak to your Stop Smoking Practitioner.

Strong desire or craving for nicotine

First, try using more of your lozenges or inhalator – this should help. Try your best to avoid situations and places that remind you strongly of smoking. If this is not possible, remind yourself that cravings will only last a few minutes and arm yourself to be able to resist them better. See 'Tips for dealing with persistent cravings'.

Itching and mild reddening of the skin with the patch

Skin irritation is usually caused by not changing the site of application daily. Irritation should disappear if you put the patch in a different place each day. Avoid sensitive areas of skin, like the stomach and inner thighs. You can use a topical cream if itching/redness persists after moving the application site, but don’t apply any creams to the area where the patch is to be applied. If the skin becomes painful or blisters, you should stop using the patch and speak to your Stop Smoking Practitioner.

Irritability, frustration, anger or anxiety

First, try using more of your lozenges or inhalator. Remember that your brain is adjusting to being without cigarettes and you’ll feel much better mentally within a few weeks of quitting - providing you don’t smoke at all. If you can, remove yourself from situations that trigger anger and frustration, and get outside for some air or light exercise until you calm down. Try talking to a friend – and ask others to be sympathetic while you kick your habit. Learning some relaxation techniques could help you to cope with  anger better in the future.

Irritation of the mouth, tongue or throat (including coughing) when taking NRT by mouth (e.g. lozenges)

Make sure you are using the product correctly - dissolve lozenges slowly, don’t chew them! Symptoms usually settle with time but - if symptoms persist and are troublesome - speak to your Stop Smoking Practitioner. You could consider trying the NRT inhalator instead.

Low / depressed mood

First, try using more of your lozenges or inhalator. As above, remember that your brain is adjusting to being without cigarettes and you should feel much better mentally within a few weeks of quitting provided you stay smoke free. Smokers are less depressed and anxious after they quit. Feel very proud of yourself for trying to quit and try not to let any setbacks upset you - see our section on dealing with slips and relapse. If you’ve had problems with depression in the past, or feel very down for a prolonged time, you should speak to your midwife or GP about this – it might be unrelated to your quitting smoking.

Upset stomach, nausea, indigestion / heartburn, hiccups (more common with lozenges)

Make sure you are using the product correctly – dissolve lozenges slowly, don’t chew them! Symptoms usually settle with time. Stick to eating plain, simple foods. If you are suffering from morning sickness, the NRT inhalator may be a better choice for you than the lozenges.

Feeling restless / difficulty concentrating

First, try using more of your lozenges or inhalator. If this doesn’t help try some exercise.

Headaches

Headaches can be a side effect of NRT but are also very common in pregnancy (due to increased hormones). Make sure you drink plenty of fluids to prevent dehydration, get enough sleep, and try to rest and relax. Practice relaxation techniques like deep breathing exercises or yoga. It’s ok to take paracetamol in pregnancy (with the advice of your midwife, GP or pharmacist) - but other painkillers should be avoided unless prescribed by your doctor.

Increased appetite

First, try using more of your lozenges or inhalator. If this doesn’t help, try to snack on healthy foods (e.g. extra fruit and vegetables) – this will do you and your baby good. You could try chewing on sugar-free gum or sucking mints to keep your mouth occupied. Try not to worry about weight gain when pregnant – be kind to yourself! Quitting smoking is the greatest thing you can do for your health.

Dizziness

Dizziness usually goes away on its own. Lie down if possible (or sit) until it passes, then get up slowly, move slowly, get plenty of rest, and drink plenty of fluids. Don’t do anything that could be dangerous if you’re feeling dizzy. Try avoiding caffeine. Don’t bend down suddenly, or get up suddenly after sitting or lying down.

Constipation

First, try using more of your lozenges or inhalator - constipation is a common, temporary side effect of  coming off cigarettes. If this doesn’t help, try increasing the amount of fibre-rich foods in your diet and be sure to keep your fluid levels topped up to keep you hydrated. Don’t drink or eat at the same time as using lozenges though.

Palpitations (heart racing)

This feeling should soon settle. If you are worried or it becomes troublesome, speak with your Stop Smoking Practitioner.

Tingling feelings

First, try using more of your lozenges or inhalator. These should go after a while, but speak to your Stop Smoking Practitioner if not.

Dry mouth (or increased salivation), swallowing problems

Some products taken by mouth (e.g. lozenges) can cause these symptoms. Drink plenty of water and – for dry mouth – try chewing sugar-free gum or suck on sugar-free sweets. Don’t drink or eat at the same time as using lozenges though. If symptoms are   troublesome, speak to your Stop Smoking Practitioner. You could consider trying the NRT inhalator instead.

Changes in bowel habit, bloating, wind

It is common to experience more wind than usual during pregnancy. Make sure you drink plenty of water, opt for smaller meals with regular snacks, try to relax and - if you are experiencing indegestion or heartburn - an over-the-counter antacid made of calcium carbonate might help.

Difficulty sleeping*, sometimes with vivid dreams

Take your patch off before bedtime (whether you use a 16 hour or 24 hour patch). Avoid screen time (i.e. portable electronic devices) for one to two hours before bedtime. Have a bedtime ritual, such as reading, taking a shower / warm bath, or listening to calming music. Avoid caffeine or heavy meals before bedtime.