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Want To Quit Smoking? Nicotine Replacement Therapy Not As Safe As Believed, Say Experts

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Trying to kick the habit of smoking is never easy, but doing so is possible.

One of the ways people quit is through nicotine replacement therapy (NRT). Nicotine is delivered into the bloodstream in patches, sprays, gums, inhalers or lozenges without the toxic chemicals present in cigarettes.

About 70 to 90 percent of smokers fail to quit because of cravings and withdrawal symptoms, according to the American Cancer Society. This is where NRT comes in: small amounts of nicotine are lesser than those in cigarettes, but are enough to manage withdrawal symptoms and reduce cravings.

However, a report featured in the Journal of Health Psychology revealed that NRT may not be as safe or effective as experts previously thought.

Nicotine In Pregnant Women And Children

The practice of NRT has expanded even to pregnant women, infants and adolescents.

The authors of the report said this expansion completely ignores the negative effects of nicotine, especially the fact that it disrupts, impairs, duplicates and interacts with vital bodily functions. Nicotine also increases the risk for the formation of tobacco-related cancers.

Allowing the use of NRT in pregnant women harms the fetus in the womb, consequently causing mental or physical retardation and death. Small doses of nicotine can damage the development of the embryo and elevate the chances for the progression of affective, cognitive and behavioral disorders in children.

"[T]he use of nicotine, whose efficacy in treating nicotine addiction is controversial even in adults, must be strictly avoided in pregnancy, breastfeeding, childhood and adolescence," the authors wrote.

The Harmful Effects Of Nicotine

Dr. Pankaj Chaturvedi of Tata Memorial Hospital in Mumbai said the use of NRT has not made dramatic impact to public health.

Chaturvedi and his team showed the detrimental and systemic effects of nicotine on the body's vital organs. By assessing the PubMed and Medline database, researchers evaluated previous human and animal studies that focused on how nicotine affected the organ systems.

In the end, the study concluded that nicotine poses health hazards such as heightened risk for respiratory, cardiovascular and gastrointestinal diseases. Nicotine also harms a person's immune system and the reproductive health. It causes the growth of cancerous tumors and a person's resistance to chemotherapy and radio therapy.

Symptoms Of Nicotine Overdose

Chaturvedi said people who are addicted to smoking use synthetic nicotine to counter withdrawal symptoms, but simultaneous use of cigarettes and NRT can lead to dangerous overdoses.

Some of the symptoms include headache, belly pain, vomiting, nausea, diarrhea, agitation, cold sweat, irregular heartbeat, weakness, tremors, confusion and weakness, high blood pressure which drops afterwards, seizures and fast breathing that may stop later.

What Experts Say About NRT

Chaturvedi said the marketing of NRT and the unsupervised usage of nicotine poses a dangerous threat to society. Nicotine should only be used under the advice of cessation experts, he said.

Over-the-counter sale and commercial advertisement of NRT, especially e-cigarettes, should be prohibited, Chaturvedi suggested, as e-cigarettes have high levels of nicotine that are just as harmful.

"All NRT products must carry appropriate warning to share harmful effects with innocent users," said Chaturvedi.

Still, other experts believe that NRT can actually protect users from carcinogenic chemicals found in cigarettes. Dr. Lancelot Pinto of Hinduja Hospital said that using NRT is the right way to gradually withdraw from smoking, and that proper NRT usage schedule can help the user until he or she no longer needs nicotine.

"It should be strictly used along with cessation of smoking, as dual consumption might be harmful," said Pinto.

Cytisine Is More Effective Than NRT

A study in New Zealand revealed that a plant-based drug called cytisine may be more effective and safer than NRT when it comes to quitting the habit of smoking.

By examining 1,300 men and women who contacted a smoking hotline in the country, Natalie Walker and her team found that 31 percent of participants who used NRT reported that they had not smoked, while the number is higher for participants who took cytisine pills at 40 percent.

Walker said the brain perceives cytisine as nicotine. The chemical also reduces the urge to smoke and the severity of withdrawal symptoms.

Three in every 10 cytisine users reported some side-effects that did not last long. For NRT users, two in every 10 users reported unwanted effects. For both groups, the side-effects included nausea, bad dreams and vomiting.

Compared with other products, cytisine pills are much more affordable.

"The real appeal is for low- and middle-income countries because they can't even afford nicotine replacement therapy but they could afford cytisine," said Walker.

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