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Nicotine Replacement Therapy (NRT)
What Is It?
Nicotine gum is a nicotine-containing product that is designed to slowly release nicotine into the mouth when chewed
and placed between the cheek and gums. Unlike the nicotine in smoke, which passes almost instantaneously into the blood
through the lining of the lungs, nicotine in the gum takes several minutes to reach the brain. This makes the "hit" less
intense with the gum than with a cigarette. Using nicotine gum increases the likelihood of successfully quitting smoking
by about 50% compared to using no quit smoking medication.
How do I use nicotine gum?
Nicotine gum is not designed to be chewed like normal gum, so use the "chew and park" method. Insert a piece of gum into your mouth, chew it a few times
until you notice a peppery taste, and then "park" it in your cheek and leave it alone. Nicotine will enter your system via blood vessels in the mouth.
If you continue chewing without parking, the nicotine will be released directly into the saliva; you'll eventually swallow it and become nauseated. Chew and park
intermittently for half an hour or so. Acidic beverages, including sodas, can interfere with the efficacy of the gum, so avoid them for 15 minutes before and after using.
Many people who use the gum either pick the wrong dose, use too little of it, or stop use too soon, and are more likely to relapse as a result. Make sure that you read the directions inside the pack
and follow your doctor's instructions carefully. Inadequate dosing or too-infrequent use will result in withdrawal symptoms similar to abruptly stopping smoking.
What is the dose?
To help you determine if gum is right for you, you may consider using the QuitNet Medication Wizard.
- One piece of gum is one dose; the strength of the gum is determined by "Time to First Cigarette" (TTFC). If you typically smoked your first cigarette within 30 minutes of awakening, you should use the 4mg gum; more than 30 minutes to the first cigarette indicates the 2mg gum.
- One piece of gum every 1-2 hours for the first six weeks; one piece every 2-4 hours during weeks 7-9; one piece every 4-8 hours during the final weeks 10-12.
- Do not use more than 24 pieces in a day.
More medically specific information ...
Alan S. Peters, CTTS-M
Ann Wendling, MD, MPH, April 2013