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Combination NRT is the use of a nicotine patch, to provide nicotine for all day craving control, along with a fast-acting flexible format for fast craving relief.

NICORETTE® offers a wide range of NRT formats

Support your patients to help them quit smoking with combination NRT

The benefits of NRT

  • • Combination NRT has been shown to be more effective than the use of a single NRT product1

  • • Combination NRT is the use of a nicotine patch, which provides a steady supply of nicotine, along with a fast-acting flexible format to help with immediate cravings1,3

  • • The safety profile of combination NRT is comparable to monotherapy7,8 and even with combination NRT, the levels of nicotine received are unlikely to be higher than those received from smoking9

  • • Data from a Cochrane review showed that, compared with the use of single NRT products, combination NRT can increase long-term quit rates by 25%1

Combination NRT is recognised by NICE and NCSCT, and is recommended for smokers who want to quit3,9.

NCSCT, National Centre for Smoking Cessation and Training; NICE, National Institute for Health and Care Excellence; NRT, nicotine replacement therapy.

Why NRT?

  • NRT has been shown to be an effective pharmacotherapy2

  • It provides a temporary substitute for the nicotine that smokers receive from cigarettes and delivers nicotine without the other harmful toxins that are found in tobacco2,3

  • The use of NRT aims to assist smokers who want to quit by helping to relieve the urge to smoke along with nicotine withdrawal symptoms, such as irritability, low mood and restlessness2,4

  • Absorption of nicotine from NRT is either mucosal (oral and nasal formats) or transdermal (patch)5

  • While transferred nicotine dependence from cigarettes to NRT is rare, it is both less harmful and easier to break than smoking dependence3,6

Combination NRT learning video

Example scenarios

Tony wants some advice.

He has been smoking for 10 years, and tried to give up once before, about three years ago. He managed to stop for a couple of months using nicotine patches, but started again when he started socialising with work more often.

He found dealing with the cravings really difficult. His wife is expecting and he wants to stop for good. He smokes around 15-20 a day, and has cravings for an early morning cigarette.

Recommendations:

A combination of long-acting and short-acting NRT could be an appropriate option, as Tony struggles with dealing with cravings (including early morning ones).

A 25mg Invisipatch is suitable for those who smoke over 10 cigarettes a day, while the QuickMist mouthspray will help with breakthrough nicotine cravings.

Raminder is determined to give up smoking, but finds it difficult to break the habit.

She smokes socially when out with friends, and no more than 6 to 8 a day. She enjoys the social aspect and is worried about putting on weight if she stops.

What product and advice is most appropriate?

Recommendations:

Nicorette Inhalator is held like a cigarette and suitable for light and heavy smokers.

Using NRT may also help control weight gain10, but also consider recommending an appropriate diet and increasing exercise if she is concerned about weight gain.

Combination NRT learning materials

this needs to be an image of the combi 1 pager (woman on bike)

View the Combination Therapy Leaflet

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View the NICORETTE® Range Guide

References

1. Lindson N et al. Cochrane Database Syst Rev 2019;4:CD013308.
2. Hartmann-Boyce J et al. Cochrane Database Syst Rev 2018;5:CD000146.
3. NICE guideline NG209. Tobacco: preventing uptake, promoting quitting and treating dependence. Aug 2022. Available here. Accessed: Nov 2022.
4. West R and Shiffman S. Psychopharmacology 2001;155:115–122.
5. Wadgave U and Nagesh L. Int J Health Sci (Qassim) 2016;10(3):425–435.
6. Nicorette Invisi 25 mg Patch Summary of Product Characteristics. Available here. Accessed: November 2022.
7. Cahill K et al. Cochrane Database Syst Rev 2013;5:CD009329.
8. Kornitzer M et al. Prev Med 1995;24:41–47.
9. National Centre for Smoking Cessation and Training (NCSCT). Briefing: 3. Combination nicotine replacement therapy 2012. Available here. Accessed: November 2022.
10. Nicorette Inhalator Summary of Product Characteristics. Available here. Accessed: December 2022.

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