New Delhi : Tobacco addiction remains a global menace, responsible for one death every six seconds worldwide and over a million deaths in India alone, constituting 9.5% of all deaths. Nicotine Replacement Therapy (NRT) has been a crucial tool in the fight against smoking for over 25 years. NRT offers a 50% higher probability of quitting smoking compared to attempting to quit without it, and it is both safe and readily available without the need for a prescription.
Dr. Chandrakant S Pandav, former Head of the Department of Community Medicine at AIIMS, New Delhi, and recipient of the Padma Shri Award, while emphasizing the pressing need for improved access to tobacco cessation methods in India said, “Tobacco use afflicts 28.6% of adults in the country, with a particularly significant impact on 42% of men and 14.2% of women. Challenges continue to exist in challenging geographic locations and rural areas, highlighting the importance of making NRT accessible over the counter (OTC). Dr. Pandav believes that easier access to NRT without prescriptions empowers individuals to quit smoking.”
Nicotine, the primary addictive component in cigarettes, delivers rapid pleasurable effects through smoking. NRT, on the other hand, serves as a temporary replacement for a small quantity of nicotine, controlling cravings, alleviating withdrawal symptoms and facilitating the transition to tobacco abstinence. Unlike cigarettes, NRT provides a gradual and very small increase in blood nicotine levels, which discourages misuse. The aim of NRT is to enable people to quit smoking with the help of nicotine delivery systems with reduced addictiveness.
Dr Sajeela Maini, Head, Tobacco Cessation, De-addiction, Mental Health Expert, Sir Gangaram Hospital, New Delhi, said “In my years of practice in smoking cessation, I have found that Nicotine Replacement Therapy is the mainstay of Smoking Cessation Therapy. Substituting cigarettes with a nicotine product works the best. It is most effective in reducing the urges, and withdrawals of quitting the stick. Tobacco dependence is a mind-body addiction. We need to address both the physiology and psychology of addiction in proper perspective, to be effective. Pharmacotherapy, per se, has a supportive role in reducing the urges and withdrawals of quitting and making the process less discomforting. To ensure the success of our smoking cessation endeavours, we should concentrate on enhanced access to NRT. Tobacco addiction is one of the most widespread addictions in the world. In fact, we need a multi-pronged approach to arrest this menace. Tobacco cessation is still in its infancy in India. We need to educate the public pro-actively about scientifically-backed options like NRT to assist them in quitting smoking and thus prevent them from developing tobaccosis – spectrum of diseases caused by smoking, and chewing of tobacco”.
Dr. Pandav also points to Indian trials conducted in 2023, such as the one in Odisha, which demonstrated the efficacy of NRT in halting smokeless tobacco use—a specific issue in India. Another study in Bengaluru in the same year highlighted the effectiveness of combining NRT with behavioural counselling in reducing cigarette smoking.
