Which nicotine replacement therapy is most commonly associated with nasal irritation?

• A. Nicotine inhaler
• B. Nicotine nasal spray
• C. Transdermal patch
• D. Nicotine gum

Answer: (B)

When a nicotine replacement therapy is delivered through a particular route, the local irritation tends to occur at the tissues that are in direct contact with it. Nicotine nasal spray delivers nicotine straight to the nasal mucosa, so it commonly causes irritation there—burning, stinging, or a runny nose—because the nasal passages are directly exposed to nicotine and the spray’s formulation.

The rapid absorption through the nasal tissues also means higher local nicotine levels in that area, which reinforces this irritation pattern. Other forms work through different tissues: gum affects the mouth and jaw, the patch sits on the skin, and the inhaler delivers nicotine to the mouth and throat. These routes produce irritation in those respective sites rather than in the nasal passages. So the nasal spray is the form most commonly linked to nasal irritation.