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Faster-acting
nicotine products are those producing a rapid increase in blood
nicotine – more closely mimicking the effect of smoking a
cigarette. Several products are in development.
Safety. Nicotine-only products have
virtually zero risk, while the tobacco snuffs have about 5 percent of
the risk of smoking. Ideally nicotine-only products should make tobacco
snuffs unnecessary.
Acceptability These fast-acting
products could provide nicotine to suit the tastes and preferences of
many smokers, if priced attractively.
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Efficacy. We cannot say at this stage whether
fast-acting nicotine products will be sufficient to speed up the
decrease in the percentage of adults who smoke. If fast acting nicotine
cannot do it, attention will turn to the tobacco snuffs, as used in Sweden.
Addiction maintenance. Whether fast
acting nicotine will maintain addiction is not yet known. To seriously reduce
smoking, nicotine products have to persuade the addicted smoker to switch
from cigarettes to self-dose with smokeless nicotine.
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Please click on www.smokeless.org.nz/BldnicNRTcigs12Mar.pdf
This graph shows
the effect of a single cigarette versus a single dose of various types
of NRT over one hour.
The cigarette raises serum nicotine levels faster than most
current medicinal nicotine replacement products.
In the gap between
the cigarette and the nicotine nasal spray nicotine plot line there is
room for faster-release nicotine products to more nearly mimic the
action of a cigarette. Oral snuff can also fill this gap. www.smokeless.org.nz/snus.htm
Fig 2, as may nasal snuff. www.smokeless.org.nz/nasalsnuff.htm
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Fast
acting nicotine-only products include
·
Fast release nicotine
gum.*
Not yet marketed.
·
Nicotine nasal spray.This has been sold in New Zealand but is no longer
stocked.
·
NicoNovum products: Nicotine mouth spray, Nicotine
lozenge, Nicotine granules in pouch form. Under research, 2007. www.niconovum.com
*Niaura R, Sayette M, Shiffman
S, Glover ED, Nides M, et al. Comparative
efficacy of rapid-release nicotine gum versus nicotine polacrilex gum in relieving smoking cue-provoked
craving. Addiction. 2005 Nov; 100(11):1720-30.
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Tobacco snuffs are also
fast-acting nicotine products:
·
Snus (finely ground
tobacco) raises serum nicotine levels rapidly. www.smokeless.org.nz/snus.htm
at Fig. 2. With further hourly doses, snus increases nicotine blood
levels above the level from nicotine gum. www.smokeless.org.nz/BldnicSnus.pdf
Nasal snuff. Finely ground tobacco
snuff can produce a nicotine effect within two minutes. No trials of
the effects of this traditional form of tobacco have been conducted in New Zealand. Swedish Match
will test market nasal snuff in 2007. www.smokeless.org.nz/nasalsnuff.htm
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