What is Nicotine Replacement Therapy?
Nicotine replacement therapy (NRT) aims to reduce withdrawal symptoms associated with stopping smoking by replacing the nicotine from cigarettes.
NRT is available in many forms: skin patches that deliver nicotine slowly, chewing gum, nasal and oral sprays, inhalers, and lozenges/tablets, all of which deliver nicotine to the brain more quickly than delivered through skin patches, but less rapidly than from smoking cigarettes.
Nicotine is the main substance in tobacco that causes addiction – it makes people dependent on cigarettes – but it is the other chemicals in combusted tobacco that cause cancer, accelerate heart disease and affect other areas of health.1
How effective is Nicotine Replacement Therapy?
To assist with the reduction of withdrawal symptoms and cravings, NRT releases smaller and measured dose of nicotine through an individual’s bloodstream. The aim of NRT is to replace some of the nicotine from cigarettes without the harmful constituents found in tobacco smoke. 2 NRT reduces the physical withdrawal symptoms associated with nicotine addiction, allowing the smoker to focus on the behavioural and sensory aspects of quitting smoking.3
NRT appears to be a safe and effective option for smokers who wish to quit. NRT’s ability to increase the chance of quitting smoking by 50-70% compared to quitting without help. 1 The replacement therapy works with or without additional counselling, however counselling further increases the odds of success.
Combining two forms of NRT (patch plus oral form, such as gum or lozenge) has also been shown to be more efficacious than a single form of nicotine replacement. The patch provides a steady background nicotine level and the oral forms provide relief for breakthrough cravings as needed. 3
Pharmaceutical Benefits Scheme
The Australian Government is committed to improving the capability of the Pharmaceutical Benefits Scheme (PBS) to better meet the needs of all Australians. The scheme began as a limited scheme in 1948, and today provides timely, reliable and affordable access to necessary medicines.4
The PBS is available to all Australian residents who hold a current Medicare card and provides access to overseas visitors from countries with which Australia has a Reciprocal Health Care Agreement (RHCA). Further information on which countries has a RHCA with Australia, visit the Department of Health Pharmaceutical Benefits Scheme.
What NRT is subsidised under PBS?
The Australian Government subsidises many medicines that are necessary to maintain the health of the community in a way that is cost effective.
The Government’s subsidies include bupropion (Zyban®), varenicline (Champix®) and NRT (available in the form of patches), including a continuation course (12 weeks or 24 weeks) of varenicline. 5 These products are available under the PBS for all eligible Australians (including concession cardholders). All products are available at a reduced price for eligible patients through the PBS with a prescription from a general practitioner.
In 2018, concessional patients such as pensioners only pay $6.40 per PBS prescription and general patients pay $39.50.6
Aboriginal and Torres Strait Islander people
People who identify as Aboriginal and Torres Strait Islander peoples qualify for PBS authority listing that provides up to two courses per year of nicotine patches, each of a maximum of 12 weeks. Under this listing, participation in a support and counselling program is recommended but not mandatory. Access to nicotine patches for Aboriginal and Torres Strait Islander people can be facilitated through the Closing the Gap PBS co-payment measure.7
Further information: Pharmaceutical Benefits Scheme
For more on frequently asked PBS questions: PBS Frequently Asked Questions
1Stead LF, Perera R, Bullen C, Mant D, Hartmann‐Boyce J, Cahill K, Lancaster T. Nicotine replacement therapy for smoking cessation. Cochrane Database of Systematic Reviews 2012, Issue 11. Art. No.: CD000146. DOI: 10.1002/14651858.CD000146.pub4.
Available at: https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0010505/.
2Nicotine Replacement Therapy (NRT) – Cancer Council. Available at: https://www.cancersa.org.au/search?q=what+is+NRt.
3Nicotine replacement therapy – Clinical guidelines – RACGP - The Royal Australian College of General Practitioners. Available at:https://www.racgp.org.au/your-practice/guidelines/smoking-cessation/pharmacotherapy-for-smoking-cessation/nicotine-replacement-therapy/.
4About the PBS – The Pharmaceutical Benefits Scheme. Available at:http://www.pbs.gov.au/info/about-the-pbs#Who_is_eligible_for_the_PBS.
5Get ready to quit. Available at: https://campaigns.health.gov.au/smokes/get-ready-quit.
6What are the current patient fees and charges? – The Pharmaceutical Benefits Scheme. Available at: http://www.pbs.gov.au/info/about-the-pbs#Who_is_eligible_for_a_concession.
7Aboriginal and Torres Strait Islander people - RACGP – The Royal Australian College of General Practitioners. Available at:https://www.racgp.org.au/your-practice/guidelines/smoking-cessation/pharmacotherapy-for-smoking-cessation/nicotine-replacement-therapy/.