Nicotine Gum

Nicotine is the addictive chemical in tobacco. Nicotine gum can help people quit smoking, especially when it is used with a program to change behavior. Nicotine gum helps to control withdrawal symptoms and cravings. It can double the rate of quitting.

Nicotine gum is sugar-free. It is available over the counter for people at least 18 years old, so you don’t need a prescription. The brand name is Nicorette. It comes in different flavors. Store brands (generic) are also available.

How does nicotine gum work?

When you chew nicotine gum, it releases nicotine. The nicotine goes through the lining of your mouth and into your bloodstream. In your blood, it replaces some of the nicotine you used to get from smoking cigarettes. There is less nicotine in gum than in cigarettes, so the amount of nicotine in the blood is lower with the gum than with cigarettes. It is still high enough to decrease cravings and withdrawal symptoms like irritability, frustration, anger, anxiety, difficulty concentrating, and restlessness. Nicotine gum also provides some oral satisfaction.

With gum, you do not take in carbon monoxide, tar, and other chemicals that you get from smoking. It is much safer to use nicotine gum to help you quit smoking than to keep smoking.

How does nicotine gum help you quit smoking?

Certain situations, feelings, and people can make you feel like smoking. These are called triggers. You can avoid some of these triggers. Some triggers are difficult or impossible to avoid. If you can’t avoid a trigger, it is helpful to think about how you will deal with the situation ahead of time.

The urge to smoke may happen often when you first quit smoking. Prepare yourself for these situations. Have the gum available to help control your urge to smoke. If you don’t plan for your urges, you are more likely to start smoking again. In addition to helping you deal with these triggers caused by habits and feelings, nicotine gum also helps you with your addiction to nicotine.

How much gum should you use?

Nicotine gum comes in 2 strengths. You and your doctor can choose which strength is right for you. You will work your way off of nicotine little by little. Eventually, you will stop using nicotine completely.
Generally, if you smoke 25 or more cigarettes per day, choose the 4 mg strength. If you smoke fewer than 25 cigarettes per day, choose the 2 mg strength.

 

The following chart shows how much nicotine gum you should use during the weeks after you quit smoking:

 

Weeks After Quitting Number of Pieces
1 to 6

1 piece every 1 to 2 hours

7 to 9

 1 piece every 2 to 4 hours

10 to 12

1 piece every 4 to 8 hours

 

Using nicotine gum on a regular basis will help you to prevent cravings. You can also use additional pieces of gum to help stop cravings when you do get them. You should not use more than 24 pieces per day.

How to chew nicotine gum

Chewing nicotine gum is not like chewing regular gum. There is a certain way you should chew and park nicotine gum. This method helps your body absorb the nicotine and lessen side effects. Parking means putting the gum between your cheek and gum and holding it there. When you chew the gum, the nicotine is released. When you park the gum, the nicotine is absorbed through your mouth into your blood.

Steps for chewing nicotine gum

  1. Warm the gum in your mouth for 1 to 2 minutes.
  2. Chew slowly until you feel a slight tingling or peppery taste in your mouth. It takes about 15 chews to have these feelings.
  3. When you feel tingling or have the peppery taste, stop chewing. Place (park) the gum between your cheek and gums.
  4. In about a minute, the taste or tingling will go away. Chew and park the gum again. Put the gum in a different spot in your mouth every time you park it. This will help to keep you from getting mouth ulcers. You should also try to avoid chewing in areas of your mouth that have fillings or crowns.
  5. Continue to chew and park for about 30 minutes. At this point, most of the nicotine is gone from the gum. You can now rinse your mouth with water or mouthwash.

Most of the time the gum is in your mouth, it should be parked. Chew only 1 piece of gum at a time.

Using nicotine gum effectively

You should not drink coffee, juice, cola, milk, tea, or beer right before or while chewing nicotine gum. The acid in these drinks keeps your body from absorbing nicotine. After you take a drink, wait15 minutes before using the gum. You should also wait 15 minutes after eating.

Start chewing the gum before your craving for a cigarette gets too strong. It takes longer for the level of nicotine in your blood to rise with gum (20 minutes) than with smoking (7 seconds).

How to prevent side effects

Nicotine gum is a medicine. You can have side effects from using nicotine gum. Chew nicotine gum slowly. If you chew the gum too fast, you could have sore jaw muscles. Your mouth will also make extra saliva. Extra saliva makes you more likely to swallow nicotine. Nicotine doesn’t absorb into your blood well when you swallow it. If you swallow too much nicotine, you may get the hiccups, nausea, or gas. It will help if you chew very slowly and hold your head forward. This helps your cheeks absorb more saliva. Be careful not to swallow your saliva right away. You should wait 45 seconds to 1 minute to swallow after you are done chewing. Most people get a lot of extra saliva only when they first start using the gum.

 

You may feel a burning sensation when you begin chewing nicotine gum. If you feel burning, slow your rate of chewing. This helps to slow the release of nicotine, which will decrease the burning. Most people get used to the taste and burning in a few days. If you feel light-headed while chewing the gum, you may be chewing it too fast.

Mouth sores

Many people who use nicotine gum get sores in their mouth, sometimes called mouth ulcers. No one is sure that the nicotine gum actually causes the ulcers. Smoking may inhibit mouth ulcers. People may get mouth ulcers because they quit smoking, not because they use nicotine gum. The ulcers do not last any longer than ulcers that the person may have had in the past.

If you get sore spots in your mouth:

  • Chew slowly, away from the sore spot
  • Change chewing and parking sites often
  • Tell your doctor and dentist

When to call your doctor

A very small number of people have had headaches, heart palpitations, or dizziness while using nicotine gum. If you have any of these side effects or any other disturbing sensations, tell your doctor.

Precautions

Nicotine should be kept out of reach of children and pets. Even used gum can have enough nicotine left to harm children and pets. Wrap used nicotine gum in a sealed plastic bag and throw it away in a garbage can with a sealed lid. If a child chews or swallows one or more pieces of nicotine gum, call a poison control center or your doctor immediately.

Do not smoke cigarettes or use other tobacco products while you are chewing nicotine gum. Taking nicotine into your body from both gum and cigarettes at the same time could cause nicotine toxicity (talks-ISS-it-ee). Toxicity means poisoning.

Signs of nicotine toxicity include:

  • Headaches
  • Nausea
  • Abdominal pain
  • Vomiting
  • Diarrhea
  • Sweating
  • Salivation
  • Flushing
  • Dizziness
  • Hearing and vision disturbances
  • Confusion 
  • Weakness
  • Tremor
  • Palpitations
  • Breathing problems
  • Decreased blood pressure

 

 

Storing nicotine gum

Store nicotine gum at room temperature. Do not keep it in the trunk or glove compartment of your car in warm weather. Keep it out of sunlight and heat so that it does not get sticky. Use the nicotine gum as soon as you take it out of the package. It may lose strength if it is kept outside its package.

Can anyone use nicotine gum?

Talk to your doctor about whether nicotine gum is right for you. Some conditions may keep you from using nicotine gum, including:

  • Temporomandibular joint disease (TMJ). TMJ is a disease which involves the joint that connects the lower jaw to the skull.
  • Pregnancy or breastfeeding
  • Recent heart attack
  • Irregular heart beat
  • Severe or worsening heart pain (angina)
  • Allergies to nicotine
  • Esophageal reflux
  • Active stomach ulcers
  • Very high blood pressure

Dentures and dental work may cause problems. Some people with dentures are not able to chew the gum, but others can. If you have dentures or dental work, it may help to avoid very hot or cold liquids before chewing. You may not be able to chew nicotine gum while you have a cold or flu with a sore throat.

The makers of Nicorette offer a support program to help you quit smoking. You will find the toll-free number in the package. The websites are www.nicorette.com and www.committedquitters.com.

If you want help to stop smoking:

  • Classes may be available in your community. Call 1-800-553-UPMC (8762) to find out more.
  • If you are an inpatient at a UPMC hospital:
      • Ask your nurse if the hospital has the UPMC patient education TV channel, which features a video about quitting smoking.
      • Ask to talk one-on-one with a smoking cessation counselor.
  • Go to UPMC’s patient education website (http://patienteducation. upmc.com). Under the Smoking category is Journey to a Smoke Free Life, a 42-page guide that can help you devise a successful strategy to quit smoking, as well as other materials about the dangers of smoking and other health topics. You can print out any or all of these materials.
  • Additional resources are available from the toll-free Pennsylvania Department of Health Quit Line. Call 1-877-724-1090.

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