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Smoking Cessation: Which over-the-counter approach will work best for you?

There are many options out there to help you quit, including several over-the-counter products that contain nicotine and come in various forms. Notify your doctor prior to starting something if you have a history of heart disease, diabetes or stomach bleeds. The most important thing is to find something that works for you and stick with it! Here are some over-the-counter options:

Nicotine Patch
The nicotine patch sends nicotine across the skin so you are receiving a constant level of nicotine throughout the day. It comes in a variety of strengths that are based on the number of cigarettes you smoke per day. Other things to keep in mind include:

  • Apply patch to clean, dry, hair free area of body.
  • Let your doctor know that you are starting a nicotine product and discuss any potential issues with your health.
  • Remove the patch at night if bizarre or vivid dreams are experienced.
  • Do not smoke with a patch on as it could lead to too much nicotine causing an increase in tremors and anxiety.
  • You may experience redness around the area of the patch.

Nicotine Gum
Nicotine gum contains nicotine that is absorbed in your mouth as you chew. Begin slowly chewing the gum. As you feel a tingling sensation in your mouth, park the gum between your gum and your cheek. As the tingling sensation goes away, begin chewing the gum again. Continue to chew like this for approximately 30 minutes or until the tingling sensation is no longer felt when chewing. Chewing the gum slowly can help avoid irritating the mouth, throat, and stomach. Other things to keep in mind include:

  • Be sure to avoid food and beverages 15 minutes before and after chewing nicotine gum.
  • Do not use other nicotine containing products while chewing nicotine gum.
  • Avoid acidic drinks as they can cause irritation to the mouth and esophagus. These include soft drinks, coffee and citrus fruit juices.
  • Nicotine gum may cause irritation in the mouth, throat, and stomach. It may also cause diarrhea.
  • It’s important to use no longer than 12 weeks unless approved by your doctor.

Nicotine lozenge
The nicotine lozenge comes in the form of hard candy that is intended to be sucked on. Nicotine is absorbed through the mouth as the hard candy is dissolved in the saliva. Other things to keep in mind are:

  • Be sure to avoid food and beverages 15 minutes before and after sucking a nicotine lozenge.
  • Nicotine lozenges may cause irritation in the mouth, throat and stomach. They may also cause diarrhea.
  • It’s important to use no longer than 12 weeks unless approved by your doctor.

Tylenol (Acetaminophen) in Prescription and Over-the-counter Products
Tylenol is a household name for acetaminophen, a drug used for relieving pain or breaking a fever. It can be found in many medicine cabinets across the US. Tylenol can be great for the occasional ache and pain, headache or fever reduction when taken as directed. However, if too much is taken over a short period of time, your liver can become damaged.

Acetaminophen overdose is a leading cause of acute liver failure and almost half of those cases occurred by accident. Not only can acetaminophen be found in the red box on the shelf of the local pharmacy, but it is also “hidden” in many products. It is commonly used in combination with prescription opioids such as Percocet, Vicodin, Norco, Fioricet and Ultracet. It can also be found in many cold/flu products that help with sore throats or aches. Make sure you read the label to see if acetaminophen is in the product you want to buy. When in doubt, consult your pharmacist.

Take home points:

  • Keep your acetaminophen intake to less than 3,000mg in a 24 hour period.
  • Only take one product that contains acetaminophen unless your doctor tells you otherwise.
  • Ask your pharmacist if any of your medications contain acetaminophen to make sure you stay under your daily limit.
  • Always read the label and take medications exactly as directed.


Over the Counter Cough and Cold Products and Hypertension

It’s cold and flu season and one of the most common symptoms that many people experience is a “stuffy nose,” otherwise known as nasal congestion. There are a few over-the-counter (OTC) nasal decongestants which work great; however, almost all of them carry warnings for people with heart problems and high blood pressure.

These decongestants work by constricting the blood vessels in the nose, decreasing the swelling in the sinuses and helping to get rid of the congestion. Unfortunately, these products also squeeze all other blood vessels in the body which causes increased blood pressure and heart rate. This can become an issue for people with high blood pressure.

If you have high blood pressure, you should avoid:

  • Sudafed (pseudoephedrine)
  • Sudafed-PE (phenylephrine)
  • Afrin (oxymetazoline)

However, there are other solutions for patients with high blood pressure that will help with symptom relief:

  • Coricidin products are marketed specifically for people with high blood pressure because the products they contain are safe for those dealing with hypertension.
  • Antihistamines have a drying effect which can help with nasal congestion.
  • Saline nasal sprays/rinses such as Ocean Nasal Spray or the Neti Pot can help rinse sinuses and possibly remove any mucus causing the congestion.
  • Cool mist humidifiers/vaporizers in the home will add moisture to the air and can relieve congestion.
  • Drinking plenty of water will help thin mucus and make it easier for your body to get rid of it.

Always remember to read labels – there are many cold/flu products that contain many ingredients. Look at the back label for any ingredients listed as a “nasal decongestant” and avoid those products. In addition, always ask your doctor or pharmacist before starting any OTC cough and cold medication.



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