Nicotine replacement therapy (NRT) refers to a range of products that deliver nicotine to the body without the harmful combustion products of tobacco smoke, helping people manage withdrawal symptoms and cravings while stopping smoking. Available forms include patches, gum, lozenges, inhalators, and nasal sprays.
Stopping smoking is one of the most powerful actions a person can take to reduce cardiovascular risk. Smoking damages the lining of blood vessels (endothelium), promotes atherosclerotic plaque formation, raises blood pressure, reduces HDL cholesterol, increases the risk of blood clotting, and causes coronary artery spasm. After cardiac arrest or heart attack, stopping smoking as part of secondary prevention substantially reduces the risk of further events.
NRT is safe for people with cardiac conditions and is recommended by NHS guidelines as a first-line aid to smoking cessation. Concerns that nicotine itself is harmful to the heart are largely unfounded at replacement therapy doses; the cardiovascular harm from smoking comes primarily from carbon monoxide and other combustion products, not nicotine. The NHS offers free NRT through GP practices and local Stop Smoking services, which also provide behavioural support.
Combination NRT (for example, a long-acting patch plus short-acting gum or spray for breakthrough cravings) is more effective than a single product alone. Varenicline (Champix) and bupropion are prescription medications that offer an alternative or addition to NRT and have robust evidence for smoking cessation. For cardiac arrest survivors, smoking cessation support should be a standard part of the cardiac rehabilitation programme.
« Back to Glossary Index