Quitting smoking can be excruciating. Most people try to kick the habit about a half dozen times before it finally sticks. The good news is that smoking-cessation systems help wean you off nicotine without massive withdrawal. But how do these products affect you while scuba diving?
Nicotine replacement therapy in the form of patches, gum, nasal spray, lollipops, lozenges or inhalers can deliver a steady stream of nicotine or a quick hit when your cravings get too intense. Studies show these products double your chances for successfully giving up cigarettes. For stubborn addiction, some doctors may also prescribe Zyban, an anti-smoking drug that helps quell nicotine withdrawal symptoms.
As yet there has been no study of nicotine replacement (e.g., Nicorette gum, NicoDerm CQ patch) and scuba diving.
Though there's nothing but benefits for quitting smoking, you should be careful about planning dives while quitting the tobacco habit. One reason is that your body produces more mucus during the first week or so after your last cigarette, as your body goes into overdrive to clean out the residual gunk. So you may be at an even greater risk for squeezes and mucous blocks.
The side effects of nicotine replacement usually are mild to nonexistent at recommended doses. Symptoms like racing heart, abdominal pain/nausea, vomiting, diarrhea, dizziness, visual/hearing abnormality, headache, flushing and confusion can occur in very sensitive individuals or in those who are getting too much nicotine.
Obviously, smoking while on nicotine replacement or using more than one replacement system at a time is not a wise idea as symptoms such as these could have implications for safe scuba. For example, racing heart could contribute to diver panic or visual/hearing abnormalities, headache and confusion could be incorrectly attributed to the drug when they actually are caused by DCI, or vice versa.
With very deep scuba on air or with nitrox diving, nicotine replacement raises the theoretical concern of increased oxygen toxicity risk due to the stimulant effects of the drug. While this very likely is an insignificant risk at best, at the least nicotine replacement would not appear to pose any greater risk than would the regular use of cigarettes during a dive trip.
Since the medication is absorbed as a chemical and not as a gas, this removes one source of concern about changes in drug activity associated with depth. Moreover, patch systems are designed to function normally while wet, although they may fall off and need to be replaced.
Whatever medications are taken by the diver, it is strongly recommended that they be given an adequate topside trial to observe for worrisome side effects and used only according to directions. Finally, you want to go into your dives calm and collected. If you go cold turkey, withdrawal symptoms are most intense for the first two to three weeks before they subside. If you use nicotine-replacement products, you'll likely be on them at least eight to 12 weeks before you start tapering down. So allow yourself plenty of time to quit the habit, clear your lungs and calm your mind before taking your next dive.
This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual and should not be construed as such.
DocVikingo has been scuba certified for more than 35 years and has dived all over the world. He is a practising doctor in the Baltimore/Washington, D.C. area and has held faculty positions at several major hospitals, including Johns Hopkins. With an interest in diving medicine, he serves as administrator at Scuba Clinic Online.