Maryland's Tobacco Resource Center - Linking Professionals to Best Practices

Nicotine Inhalers

How it works: 1

  • First introduced in 1998, the nicotine inhaler (nicknamed the "puffer") is a plastic tube with a nicotine cartridge inside. When users puff on the inhaler, the cartridge provides nicotine vapor, which unlike other inhalers, delivers most of the medication to the mouth rather than the lungs. Nicotine is then absorbed through the mucous membrane of the mouth and throat.
  • Nicotine inhalers are the closest thing to smoking a cigarette in terms of behavior, which some smokers find helpful.
  •  Inhalers are the most expensive form of nicotine replacement therapy on the market today.
  • It is recommended that inhalers be used for up to 6 months, with patients tapering their dosages towards the end of their treatments.

What the evidence says:

  • Strength of Evidence: A The Clinical Practice Guide states that the nicotine inhaler is, “appropriate as a first-line medication for treating tobacco use” with precautions for pregnant women and individuals with cardiovascular disease (DHHS, 2008, p. 49).
  • Quitting Rates
    • Research studies have found nicotine inhalers effectively and safely achieved sustained reduction in smoking over 24 months.2 A study of 223 adult smokers reported 24% success rates of smoking cessation at 3 months compared to only 10% for a placebo inhaler.3

Possible Side Effects:

  • Coughing
  • Throat irritation
  • Mouth irritation
  • Upset stomach
  • Nasal irritation

Where to get it:

  • The nicotine inhaler is available through prescription only.
  • Commercial brands include:
References: 

1. Fiore, M. C., Jaen, C. R., Baker, T. B., & al., e. (2008). Treating Tobacco Use and Dependence 2008 Update.  Clinical Practice Guideline. In U.S. Department of Health and Human Services (Ed.). Rockville, MD: U.S. Department of Health and Human Services. http://www.ahrq.gov/path/tobacco.htm2. Bolliger, C.T., et al. (2000). Smoking reduction with oral nicotine inhalers: double blind, randomized clinical trial of efficacy and safety. British Medical Journal, 321, 329-33.3. Schneider, N.G., et al. (1996). Efficacy of a nicotine inhaler in smoking cessation: A double blind, placebo-controlled trial. Addiction, 91, 1293-1306.