What is a major contraindication for nicotine replacement therapy?

Nicotine replacement therapy (NRT) is primarily contraindicated in individuals who have recently experienced a myocardial infarction. This is due to the cardiovascular effects of nicotine, which can increase heart rate and blood pressure, potentially exacerbating conditions related to heart health. In patients who have just suffered a heart attack, avoiding nicotine is essential to facilitate proper recovery and to minimize the risk of further complications.

While individuals with heart disease may need careful evaluation before starting NRT, the recent history of a myocardial infarction specifically highlights an acute risk that necessitates avoidance of nicotine. Other factors, such as liver function impairment and pregnancy complications, do warrant caution and consideration in treatment plans; however, they do not present as immediate contraindications for NRT in the same critical manner as a recent myocardial infarction does.