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How can nicotine gum (nicotine polacrilex) help me quit smoking?

Frank T. Leone, MD
Pulmonary Disease

Nicotine gum or lozenges help to treat the sudden onset of cravings. They are available in doses of 2 mg and 4 mg and can be used in combination with a nicotine patch. The advantages are that the dosage is flexible, as it is based on your cravings and helps to control weight gain. In the first few weeks of quitting, you can use one piece every hour if you need to.

Nicotine gum is a fast-acting form of replacement in which nicotine is taken in through the mucous membrane of the mouth. You can buy it over the counter without a prescription. It comes in 2 mg and 4 mg strengths.

For best results, follow the instructions on the package insert. Chew the gum slowly until you note a peppery taste. Then "park" it inside your cheek, chewing it and parking it off and on for about 20 to 30 minutes. Food and drink can affect how well the nicotine is absorbed. You should avoid acidic foods and drinks such as coffee, juices, and soft drinks for at least 15 minutes before and during gum use.

If you smoke a pack or more per day, smoke within 30 minutes of waking up, or have trouble not smoking in restricted areas, you may need to start with the higher dose (4 mg). Chew no more than 20 pieces of gum in one day. Nicotine gum is usually recommended for 1 to 3 months, with the maximum being 6 months. Tapering the amount of gum chewed may help you stop using it.

If you have sensitive skin, you may prefer the gum to the patch.

Another advantage of nicotine gum is that it allows you to control the nicotine doses. The gum can be chewed as needed or on a fixed schedule during the day. The most recent research has shown that scheduled dosing works better. A schedule of 1 to 2 pieces per hour is common. On the other hand, with an as-needed schedule, you can chew when you need it most -- when you have cravings.

Some possible side effects of nicotine gum:
  • Bad taste
  • Throat irritation
  • Mouth sores
  • Hiccups
  • Nausea
  • Jaw discomfort
  • Racing heartbeat
  • Damage to dentures and dental work
Symptoms related to the stomach and jaw are usually caused by improper use of the gum, such as swallowing the nicotine or chewing too fast.

Long-term dependence is one possible disadvantage of nicotine gum. In fact, research has shown that 15% to 20% of gum users who are able to quit smoking keep using the gum for a year or longer. Although the maximum recommended length of use is 6 months, continuing to use the gum is probably safer than going back to smoking. Still, there is little research on the health effects of long-term nicotine gum use.
 

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.