Nicotine Gum

Nicotine gum (Nicorette) is a nicotine replacement medicine. The nicotine gum is available over-the-counter. It has also been found to double chances of quitting successfully! It gives your body nicotine through the skin lining of the cheek and gums in your mouth. One nice thing about the gum is that it keeps your mouth busy. It can be a very helpful substitute not only for those who are trying to quit cigarettes but also for those trying to quit spit tobacco.

 

How to Use Nicotine Gum

Many users start with the 2-mg gum. Heavy smokers (those smoking more than 25 cigarettes per day) may start with the 4-mg gum. Nicotine gum may be used by chewing one piece of gum every one to two hours at first, or it may be used by chewing one piece of gum whenever you have the urge to smoke.

The gum should be chewed slowly until you can feel a slight tingling in your mouth. Then stop chewing and place (or park) the chewing gum between your cheek and gum. When the tingling is almost gone (about one minute), start chewing again; repeat this procedure for about 30 minutes.

Follow the nicotine gum directions closely. Do not chew nicotine gum too fast or chew more than one piece of gum at a time or you may get too much nicotine. Do not chew one piece too soon after another. Instead, space them out over the course of your day. Try not to chew more than 24 pieces of the gum per day unless your doctor gives you permission. Do not eat or drink for 15 minutes before chewing the gum, or while using it (some beverages can reduce its effectiveness).

 

Reducing the Use of Nicotine Gum

Begin to reduce the amount of gum you are using by months two and three. Slowly reducing your use over time will prevent uncomfortable withdrawal symptoms. Using the nicotine gum for longer than three or four months is not recommended. Do not use nicotine gum longer than six months without talking with your doctor.

Here are some tips to slowly reduce your gum use over time:

  • Each week, decrease the chewing time for each piece of gum by five minutes (see chart below). For example, during week one, the normal chewing time is 30 minutes per piece of gum. By week two, bring it down to 25 minutes per piece. By week three, bring it down to 20 minutes for each piece. By about six weeks of use, you will be using the gum only 5 minutes each time you chew.
  • Reduce the pieces of gum you use a day by about one piece every four to seven days. Begin to use more and more sugarless gum instead of nicotine gum.
  • Consider totally stopping the use of nicotine gum when your craving for nicotine is satisfied by one or two pieces of gum per day.
Week Chew Time Pieces per Day
1 30 minutes 18-20 pieces
2 25 minutes 16-18 pieces
3 20 minutes 14-16 pieces
4 15 minutes 12-14 pieces
5 10 minutes 10-12 pieces
6 5 minutes 8-10 pieces

Warnings

Tell your doctor if you have or have ever had:

  • Heart attack
  • Irregular heart rate
  • Angina or uncontrolled high blood pressure
  • Ulcers
  • Pheochromocytoma
  • Overactive thyroid
  • Diabetes
  • Kidney or liver disease
  • Dental condition or disorder

IMPORTANT NOTE:  Tell your doctor if you are pregnant, plan to become pregnant or are breastfeeding. If you become pregnant while using nicotine gum, stop using it and call your doctor immediately. Nicotine and nicotine gum may cause harm to the fetus or baby.

 

Ask a doctor or pharmacist before use if you are:

  • Using a non-nicotine stop smoking drug
  • Taking prescription medicine for depression or asthma; your prescription dose may need to be adjusted
  • Using a prescription and/or nonprescription medication(s), especially acetaminophen (Tylenol), caffeine, diuretics ('water pills'), imipramine (Tofranil), insulin, medications for high blood pressure, oxazepam (Serax), pentazocine (Talwin, Talwin NX, Talacen), propoxyphene (Darvon, E-Lor), propranolol (Inderal), theophylline (Theo-Dur, Slo-bid), and vitamins.

IMPORTANT NOTE:  Do not smoke cigarettes or use other nicotine products while using nicotine gum because nicotine overdose can occur. Call your doctor if you get too much nicotine (an overdose). Signs of an overdose may include dizziness, upset stomach, bad headaches, vomiting, cold sweats, confusion, blurred vision, hearing problems, weakness or fainting.

Nicotine gum may cause side effects.

 

Stop use and ask a doctor if any of the following develop:

  • Mouth ulcers
  • Jaw muscle aches
  • Dizziness
  • Headache
  • Upset stomach

 

If you experience any of the following symptoms, call your doctor immediately:

  • Seizures
  • Heart rhythm disturbances
  • Difficulty breathing

 

Effectiveness

Nicotine gum is considered safe and effective to help people quit smoking. Using the gum as directed can prevent side effects or nicotine overdose symptoms.


References

Fiore MC, Jaén CR, Baker TB, et al. Treating Tobacco Use and Dependence:  2008 Update.  Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service. May 2008.

West R, Shiffman, W. R. (2001). Effect of oral nicotine dosing forms on cigarette withdrawal symptoms and craving: a systematic review. Psychopharmacology, 155(2), 115-122.

US Department of Health and Human Services. (2000). Reducing Tobacco Use: A report of the surgeon general. Atlanta, Georgia: USDHHS, Center for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health, Office on Smoking and Health.

 

Please note, National Jewish Health does not endorse specific products. The names of NRT products are included to familiarize the consumer with the various products that are available.

 

This information has been approved by Amy Lukowski, PsyD (October 2010).

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