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Combination Nicotine Replacement Therapy

Some quitters need extra support

What is combination NRT?

Combination NRT (nicotine replacement therapy) is the use of NICODERM® patch PLUS an additional form of short-acting NICORETTE® oral NRT (gum, lozenge, inhaler, QUICKMIST®) on an as-needed basis.


Who is a good candidate for combination NRT?

icon of a broken cigarette with a “Fail” sign over top

Patients who have used NRT in a previous quit attempt but relapsed

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Patients who have had multiple failed quit attempts

icon of a nicotine patch with a “+” beside it

Patients who feel they need something more than a patch or single NRT format

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Patients who are experiencing breakthrough cravings or who have a high level of dependence

REDUCE TO QUIT® using combination therapy

Learn more about the REDUCE TO QUIT® method.

How effective is combination therapy?

Versus Monotherapy (Patch)
1.3X more effective vs. NRT patch monotherapy (aggregated relative risk of abstinence of combination therapy vs. monotherapy: 1.58 [1.25-1.99] at 12 months)1
Versus Cold Turkey
Nearly 3X more effective vs. cold turkey: Compared to cold turkey, smokers using combination NRT were nearly 3X more likely to quit for good (OR 2.73; 95% CI 2.07-3.65)2

Why do some patients need combination NRT?

Smokers’ nicotine levels vary throughout the day, resulting in a gradual build-up of trough nicotine levels and regular nicotine peaks each time they smoke.3

Monotherapy may not be able to provide both high daily baseline nicotine levels as well as the nicotine levels needed during the craving phase.3

Combination therapy was 30% more effective at 12 months than monotherapy alone1

In a meta-analysis of first-line smoking cessation pharmacotherapies 6 months after quitting4:

  • Combination therapy was similarly effective to varenicline
    • Patch (>14 weeks) plus ad lib NRT (gum or spray): OR 3.6 (2.6, 5.2 - 95% CI)
    • Varenicline: OR 3.1 (2.5, 3.8 - 95% CI)
Graph showing results of a subject study

Combination NRT using patch + an oral form of NRT enables coverage of both peak and trough levels of nicotine.

Graph showing results of a subject study


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