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Quitting Smoking With Nicorette Gum

The Food and Drug Administration approved nicotine gum (nicotine polacrilex) for prescription sale in 1984, and began allowing its sale without a prescription in February 1996.

Nicotine gum helps you quit by providing you with a source of nicotine apart from smoking. It comes in different strengths (usually 4mg or 2mg of nicotine per piece), which you choose from based on how much you smoke. Nicotine gum, like any nicotine replacement therapy, allows you to deal with the physical component of addiction over a longer period of time with less drastic withdrawal symptoms.

The advantages of nicotine gum are that you can take it when you need it (so long as you don't exceed the amount suggested by the directions), so that you can cut down on your nicotine as quickly or as slowly as you want; it is relatively inexpensive; and it provides some oral gratification of its own to replace the cigarettes.

The disadvantages are that you can't chew it while drinking soda or alcoholic beverages, so it's no good to you in a bar; it can make you feel sick if you chew it too fast; and it takes a long time for it to work, so if you wait for too long between pieces you can become extremely irritable while waiting for the piece you're chewing to affect you.

Nicotine gum allows tobacco users to break their habit in two stages: the smoker can first focus on overcoming the behavioural and psychological components of their habit without having to go through nicotine withdrawal at the same time; and they can wean themselves from nicotine at a later date of their own choosing, when there is no longer the psychological and behavioural urges to use.

The nicotine gum can be used by any interested tobacco user, but it can best benefit:

  • Heavy smokers (more than 10 cigarettes per day) or spit tobacco users who experience withdrawal symptoms when they quit.

  • Those who become extremely anxious if they go without tobacco for a few hours or days.

  • Those who prefer to control the dosage level of their Nicotine Replacement Therapy (NRT).

  • Those who intend to use nicotine gum in combination with behavioural and psychological strategies for tobacco cessation.

  • Those who derive significant satisfaction from the oral gratification of tobacco use.

  • Those who have a skin condition that could be irritated by using the nicotine patch.

Do not chew nicotine gum like ordinary chewing gum! Nicotine gum contains an ordinary chewing-gum base, but also contains nicotine bound to an inert resin. As a result of the physical action of chewing, molecules of nicotine are gradually dislodged from the resin. The nicotine is then absorbed into the bloodstream through the membranes that line the inside of the mouth. The gum also contains a buffer that maintains an acidity level that ensures the nicotine will be absorbed at a steady rate.

How to chew nicotine gum:

  • When you first put a new piece of nicotine gum in your mouth, chew it just enough to soften the medication and trigger the release of the nicotine. This usually requires chewing about 10 to 12 times. As soon as a spicy or tingling taste occurs, stop chewing, and put the piece between your gum and cheek. An occasional bite will expose a fresh surface of the gum and release more nicotine.

  • The nicotine is absorbed through the membrane on the inside of your cheek. It acts like an internal nicotine patch, providing a slow release or nicotine into your blood.

  • When the tingling sensation has disappeared, bite the gum gently once or twice to restart the release of nicotine. Vigorous chewing is not necessary. Stop again when you feel the tingle, and park the gum in your cheek again.

  • Repeat this process until you no longer feel the tingle when you bite or chew the gum. Each piece lasts about 30 minutes, although this can vary from person to person.

  • Any nicotine that is swallowed with saliva or washed down with eating or drinking will not be effective. If a substantial amount of nicotine is swallowed, it may cause such side effects as heartburn, upset stomach or hiccups. Thus, do not eat or drink while you have the gum in your mouth.

Most people find that chewing nine to 12 pieces a day controls their urge to smoke. The maximum number of pieces that can be safely chewed in a day is between 20 and 30, depending upon the type of nicotine gum.

You may not like the gum as much as smoking a cigarette, but using the gum will make it easier to go without a cigarette. Using a nicotine replacement therapy (NRT) can double the chances of successful, long-term quitting. It significantly decreases the severity of such withdrawal symptoms as irritability, anger, frustration, restlessness, impatience, sleepiness and food cravings. It appears to be particularly effective in decreasing withdrawal symptoms during the afternoon and evening hours.

Warnings and Precautions:

  • Nicotine gum may not be the right choice for those with temporomandibular joint disease (TMJ) or for those with dentures or other vulnerable dental work.

  • When nicotine gum is chewed like regular chewing gum, unpleasant side effects may be experienced which are similar to when people smoke cigarettes for the first time. Symptoms of too much nicotine include:

  • Dizziness or light headedness

  • Nausea or vomiting

  • Irritation of the mouth and throat

  • Hiccups

Other side-effects, that are often experienced when first starting to use the gum, include:

  • Aching jaw muscles from chewing the gum for long periods

  • Soreness or ulceration of the mouth

  • Headaches

  • Loud or rapid beating of the heart

  • Excessive salivation

  • Belching as the result of swallowing air while chewing the gum

Women should take precautions to avoid pregnancy while using the nicotine gum. If pregnancy occurs, the use of the gum should be discontinued.

Do not swallow the gum! Adverse effects are unlikely, but if they are experienced, contact a physician or local poison control center immediately. Nicotine overdose could occur if many pieces are chewed or swallowed in a short period of time.

Keep nicotine gum and any nicotine replacement therapy away from children and pets! If a child or pet accidentally swallows a piece of gum, contact a physician, veterinarian or local poison control center immediately.

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Updated February 2019