Starting nicotine mist sprays

The nicotine mist spray is a fast-acting formulation of nicotine replacement therapy (NRT); it takes less than 10 minutes to reach peak effect. Nicotine spray is best used as part of combination NRT with a patch and possibly also a medium-acting formulation (gum, lozenge or inhalator); for advice on how to tailor treatment, see Overview of nicotine replacement therapy and Choice of formulation of nicotine replacement therapy.

If a nicotine mist spray is chosen for NRT, use:

nicotine 1 mg/spray, 1 to 2 sprays under the tongue. Repeat as required to manage cravings, up to a maximum of 4 mg (4 sprays) per hour. Usual maximum dosage is 64 mg (64 sprays) in 24 hours. nicotine nicotine replacement therapy nicotine replacement therapy

Lifting the tongue and spraying underneath is the easiest way to maximise absorption, while reducing the risk of accidentally inhaling or swallowing the spray. If a patient has symptoms of withdrawal with mist spray use, ask about their technique; printable patient advice is available in Correct use of nicotine replacement therapy—patient information; see also patient education videos on the Quit website.