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

Nicotine Nasal Spray

How it works: 1

  • The nasal spray delivers nicotine quickly to the bloodstream as it is absorbed through the nose.
  • The nasal spray is designed to immediately relieve withdrawal symptoms and give smokers a sense of control over their nicotine cravings. However, the FDA cautions that since this product contains nicotine, it can be addictive. It has the highest dependency rate of all the available nicotine replacement therapies.
  •  It is recommended that the spray be prescribed for 3-month periods and not used for longer than 6 months.

What the evidence says:

  • Strength of Evidence: A The Clinical Practice Guide states that the nicotine nasal spray is, “ appropriate as a first-line medication for treating tobacco use” with precautions for pregnant women, individuals with cardiovascular disease, and individuals with severe reactive airway disease (DHHS, 2008, p. 51)
  • Quitting Rates
    • Abstinence rates achieved with nasal sprays are comparable to those achieved by other forms of nicotine replacement therapy.2
    • There is evidence of variability in abstinence rates following nasal spray treatment, possibly due to the adverse side effects commonly present in the first week of treatment.3 Laboratory studies have found that positive subjective effects following a dose of nasal spray were associated with increased subsequent self-administration of nasal spray.4

Possible Side Effects:

  • Nasal irritation
  • Runny nose
  • Watery eyes
  • Sneezing
  • Throat irritation
  • Coughing
  • Temporary changes in sense of smell and/or taste
  • Nasal congestion

Where to get it:

  • The nicotine nasal spray is available through prescription only.
  • Commercial brands include:
    • Nicotrol Nasal Spray :
      • Company reports that smokers who use Nicotrol nasal spray with a comprehensive behavioral smoking cessation program are more successful in quitting smoking.

 

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.htm
  1. Hurt, R.D., et al. (1998). Temporal effects of nicotine nasal spray and gum on nicotine withdrawal symptoms. Psychopharmacology, 140, 98-104.
  1. Hjalmarson, A., et al. (1994). Effect of nicotine nasal spray on smoking cessation. A randomized, placebo-controlled, double blind study. Archives of Internal Medicine, 154, 2567-72.
  1. Perkins, K.A., et al. (2000). Greater sensitivity to subjective effects of nicotine in nonsmokers high in sensation seeking. Experimental and Clinical Psychopharmacology, 8, 462-71.