Background
During recent years a gradual shift in the application of nicotine replacement therapy (NRT) has taken place from NRT-products only being recommended to achieve smoking cessation, to now including smoking reduction, and long-term substitution of tobacco with NRT has taken place. This has been promoted as a way of achieving harm-reduction in highly nicotine dependent smokers who are unwilling or incapable of quitting all nicotine products, as continued use of NRT is widely accepted as being far less hazardous than continued smoking. To our knowledge no previous research has been done, regarding long-term NRT users’ experiences with continuing the use of NRT. Results from a survey study among long-term NRT-users, who had used NRT for 12 months or more, found that out of 92 former smokers 88 % wished to quit using NRT. The primary causes stated for wishing to quit were being tired of feeling addicted, cost of NRT products and fear of adverse health consequences.

Aim of study
• To get a thorough understanding of the lived experiences of nicotine dependent long-term NRT
users.
• To investigate what motivates or discourages quitting NRT.
Method Semi-structured interviews with long-term NRT-users, who had used NRT for at least 12
months, used a minimum of 10 pieces of acute acting NRT per day and who had expressed a wish
to quit NRT. The interviews covered the following themes:
• The decision to quitting smoking.
• The expectations the participants had had to using NRT as aid for achieving smoking cessation.
• Their reasons for wishing to quit or sustain NRT-use.
• Their perspectives on the future concerning their NRT-use.

Results The results cover interviews with seven long-term NRT-users, as the investigation is ongoing. Themes that have emerged through the first seven interviews are illustrated below with headlines and quotes from the participants.

Conclusions
• None of the participants expected that they would ever begin smoking again.
• All the participants described dependence as an integrate part of themselves.
• Reasons for feeling motivated or discouraged to quit NRT were very individual and ranged from reaching an acceptance of dependence and NRT being a lesser evil than smoking, to wanting to break free from dependence and quit NRT, and experiencing the cost of NRT as a genuine financial burden.