see also:

• Western Health nicotine replacement Rx options and prescribing in ED (pdf) - intranet only

• patients attending hospitals who do not have C/I should be offered at least temporary nicotine replacement Rx whilst they are in hospital to reduce nicotine withdrawal agitation and requests to go outside for a smoke
• most hospitals now do not allow patients under mental health assessment orders to go outside even with a hospital escort die to the potential for harm to the escort, or the patient absconding

• a 2025 study suggests that striatal cholinergic interneurons play a key role in mediating some of the withdrawal symptoms such as tremors and that this can be reduced by use of procyclidine which inhibits these neurons ¹⁾

• a long acting 21mg 24hr patch (can be removed overnight if patient suffers nocturnal symptoms from the patch)
• PLUS a short acting Rx such as:
  • 2mg lozenge (must not be chewed and must be kept in mouth for 20 minutes, max. 12 per 24hrs), or,
  • 2mg gum (chew, park, chew method for 30 minutes, max. 12 per 24hrs), or,
  • 15mg cartridge inhaler (lasts 40 minutes, max. 12 per 24hrs, not for asthmatics)