Since the year 1930, health practitioners in the United States were very much aware of the dangers that smoking brought upon its users. In the year 1944, the American Cancer Association began issuing warning all over the country on the effects of smoking tobacco. Currently, cigarette smoking is one of the leading notable causes of deaths in America. Annually, more than 400,000 individuals die of tobacco-related causes in the United States (Moore, Aveyard, Connock, Wang, & Barton, 2009) . Furthermore, estimations have been done indicating that more than half of active smokers are likely to be killed by their smoking habits, while lifelong smokers lose an average of 10 years of their lives compared to nonsmokers. The Center for Disease Control and Prevention (CDC) has currently determined that approximately 18.1 percent of adults, that is, 42.1 million individuals in America are consistent smokers (Apelberg, Avila-Tang, Onicescu, & Samet, 2010) . Over 3200 underage smokers smoke tobacco for the first time. More importantly, young adults and youths who smoke become addicted to smoking. Even though the tobacco industry drive growth in the U.S. by selling over 300 billion cigarettes in a year, continued public awareness on the effects of smoking has led to the ban on public smoking, and different options and support for those who wish to quit smoking. Therefore, for those who wish to quit smoking, nicotine replacement therapy is the most effective treatment to help active smokers overcome their addiction.
The main ingredient in cigarettes is nicotine. When inhaled, nicotine crosses the blood barrier within 10 seconds, and once it reaches the brain, it triggers the release of dopamine. In consequence, active smokers begin to feel pleasure thus resulting in a reduction of their withdrawal symptoms. However, after the depletion of dopamine in the bloodstream withdrawal symptoms emerge and with it the urge to continue smoking. Individuals who try to quit smoking often experience unpleasant withdrawal symptoms ranging from depression, difficulty in concentrating and anxiety which makes them resort to smoking (American Cancer Society, 2019) . Therefore, nicotine replacement therapy (NRT) has been adopted as the most long-term effective method to help those who wish to quit smoking.
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NRT gives nicotine in the form of gum patches, inhalers, sprays or even lozenges but not the harmful chemicals that are found in tobacco. It helps in the process of quitting by relieving some of the physical withdrawal symptoms that active smokers experience, thereby, allowing them to focus on the emotional aspects of stopping (WebMD, 2019) . For instance, various studies conducted on the effectiveness of NRT in reducing the degree of smoking has shown that using NRT often doubles the chances of quitting smoking (Moore, Aveyard, Connock, Wang, & Barton, 2009) . More importantly, when combined with counseling or other support treatment programs, NRT has been shown to help in increasing the number of smokeless tobacco active users who quit.
Consequently, using nicotine replacement therapy to help active smokers quit smoking often increases the chances of an individual becoming a non-smoker. Studies have found that using slow-acting nicotine products such as patches together with a fast-acting product such as lozenges or inhalers help to reduce cigarette withdrawal symptoms such as being cranky or experiencing continuous headaches (combination therapy) (American Cancer Society, 2019) . Consistent use of the combination therapy to quit smoking reduces an individual's urge to smoke as time goes by. Additionally, NRT products have been proven as the most effective to aid in quitting smoking as they contain far less nicotine and thus are not addictive. Moreover, the body often absorbs the nicotine more slowly, and research indicates no dependency on individual who use NRT products (WebMD, 2019) . When used correctly for therapeutic treatment of cigarette addiction, they are safer for smokers compared to other treatment options.
Additionally, NRT products are not expensive and, therefore, are the most effective low-cost way of quitting smoking. Currently, people who wish to quit smoking can easily obtain NRT products at discounts with a prescription from a health practitioner. Being that most cigarette brands are highly priced at more than 30 dollars a pack, NRT products are far cheaper, and after a while, they will not be needed (American Cancer Society, 2019) . NRT products have no ongoing costs compared to smoking. Research evidence further indicates that combining personalized supports such as the Quitline with NRT products increases an individual’s chances of success in quitting smoking. In other words, NRT products reduce the strength and number of cravings to lessen the withdrawal symptoms of nicotine thus helping an individual to beat the bad habits that come with smoking.
However, even though NRT products have been proven to be effective in aiding people to quit smoking, it is not without its disadvantages which may make it not be considered as a viable option in quitting smoking. Some nicotine replacements products contain high levels of nicotine compared to those found in cigarettes and thus have severe side-effects (Apelberg, Avila-Tang, Onicescu, & Samet, 2010) . For instance, in a study conducted on NRT to aid in quitting smoking among active adult smokers, it was noted that almost two-thirds of individual respondents believed that the u se of nicotine patches to quit smoking had high likelihoods of increasing heart attack while two-thirds believed that nicotine was a major cause for cancer. Moreover, other individuals who are against NRT to help people quit smoking emphasize that although nicotine is not considered as a carcinogen, it may play a role in tumor production in a process such as angiogenesis and the inhibition of apoptosis. Normally, apoptosis is crucial for normal cell growths while the inhibition of apoptosis is one of the key components of cancer progression (Apelberg, Avila-Tang, Onicescu, & Samet, 2010) .
Consequently, NRT has been indicated to have no long-term benefits when quitting smoking. Some studies have indicated that using nicotine gum or nicotine replacement patches has no advantage in making smokers quit smoking in the long-term (Jha, 2012) . Research indicates that even though nicotine replacement therapy might be useful during the early stages of combating withdrawal, considerations have to be made on the reliance of these techniques to combat smoking. Although controlled trials on the use of NRT show that NRT doubles the likelihoods of individuals who quit smoking to remain off them for a duration of six months, other indicate the opposite (Moore, Aveyard, Connock, Wang, & Barton, 2009) . For example, studies conducted between 2001 and 2006 on the effectiveness of NRT products showed that almost a third of the individuals who had quit smoking relapsed after a few years.
Moreover, using NRT patches or gum does not reduce the chances of relapse when compared to the use of willpower or any other methods that aid in quitting smoking. In addition to this, another study conducted on the long-term effects of using NRT products to combat smoking in 789 individuals provided the same results. Out of the 789 participants, 22.6 percent had used NRT. Of these, 20.4 percent relapsed after a few years (no more than two years) (Jha, 2012) .
Basing on numerous observational and clinical trials, it is evident that active smokers who are bent on quitting smoking have high chances of succeeding if they use NRT. However, cigarette addiction is a lifelong relapsing condition thus proving to be a danger. Therefore, individuals who want to quit smoking by using nicotine replacement therapy must have a deeper understanding of the long-term use and nature of nicotine addiction. Individuals who want to quit smoking have to be serious about their quit attempts and be vigilant when their medication ends.
References
American Cancer Society. (2019). Nicotine Replacement Therapy for Quitting Tobacco. Retrieved from American Cancer Society: https://www.cancer.org/healthy/stay-away-from-tobacco/guide-quitting-smoking/nicotine-replacement-therapy.html
Apelberg, B. J., Avila-Tang, E., Onicescu, G., & Samet, J. M. (2010). Estimating the Risks and Benefits of Nicotine Replacement Therapy for Smoking Cessation in the United States. Am J Public Health , 200 (1), 341-348.
Jha, A. (2012, January 9). Nicotine replacement has no long-term benefit when quitting smoking. Retrieved February 2019, from The Guardian: https://www.theguardian.com/science
Moore, D., Aveyard, P., Connock, M., Wang, D., & Barton, P. (2009). Effectiveness and safety of nicotine replacement therapy assisted reduction to stop smoking: systematic review and meta-analysis. BMJ .
WebMD. (2019). Nicotine Replacement Therapy: What to Know. Retrieved from WebMD: https://www.webmd.com/smoking-cessation/nicotine-replacement-therapy
