When used correctly, all five NRTs have about the same efficacy, according to the 2008 Clinical Practice Guideline for treating tobacco use and dependence, published by the U.S. Department of Health and Human Services. But each method addresses a different combination of physical and psychological withdrawal.
The nicotine patch, approved by the FDA as a prescription drug in 1991 and for over-the-counter purchase in 1996, is a small square of adhesive that functions as a sort of nicotine Band-Aid. Usually attached to your upper arm, it delivers a steady but low level of nicotine through your skin and into your bloodstream. The patch was invented in the 1980s by Murray E. Jarvik, MD, the pharmacologist who first showed that nicotine was the addictive factor in cigarettes, and his student Jed Rose, PhD, who now directs the Center for Nicotine and Smoking Cessation Research at Duke University.
But what if your nicotine cravings come in bursts, not the steady sort of withdrawal that demands the patch? Thats where nicotine gum comes in. Approved by the FDA for prescription use in 1984 and over-the-counter purchase in 1996, the gum provides a surge of relief that you can control. (Lozenges, the inhaler, and the spray are also short-acting, but they are less popular because they require a prescription.)
While there is no clear front-runner among the NRTs when they are used individually, the 2008 Clinical Practice Guideline reports that combining a nicotine patch with either gum or nasal spray is more effective than the nicotine patch alone.