Nicotine Gum

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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. If you smoke 20 or more cigarettes per day or smoke within 30 minutes of waking, you can 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 after 4 weeks, and after 8 weeks. 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:

  • Use one piece of gum every 1-2 hours for the first 6 weeks. You should plan to use 9 pieces of gum per day during this time. 
  • For the next 3 weeks (Weeks 7-9), use one piece of gum every 2-4 hours, and then every 4-8 hours for another 3 weeks (Weeks 10-12). If you are experiencing cravings, you can use a second piece of gum within 1 hour, but do not use more than 2 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: It is optimal to begin using the NRT products on the day you stop using tobacco. However, it is not essential to stop using tobacco products when you begin NRT products, if you are not able to stop using tobacco at that time. If you are using an OTC NRT while trying to quit smoking but slip up and have a cigarette, you should not stop using the NRT. You should keep using the OTC NRT and keep trying to quit. 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.

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 Thomas Ylioja, MSW, PhD (December 2018).

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