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Nicotine gum to stop smoking

What is nicotine gum?

Nicotine gum is a form of nicotine replacement therapy (NRT) which can double your chances of stopping smoking compared with willpower alone.¹ It looks like chewing gum and contains a nicotine compound (nicotine polacrilex) that is designed to slowly release nicotine into the mouth when chewed. Nicotine gum is available without a prescription and in varying strengths.

How does nicotine gum work?

One piece of nicotine gum is chewed slowly for approximately 30 minutes whenever you have the urge to smoke a cigarette. No more than 15 pieces of 4mg nicotine gum should be used in any 24-hour period (or 25 pieces of 2mg gum in 24 hours).² The gum helps you to overcome any nicotine withdrawal effects from stopping smoking by slowly releasing nicotine into your body. You will still need to use willpower though, because nicotine gum alone may not completely remove the desire to smoke.

There is a correct technique to using the gum, or the full effects of it will be lost. The gum should be chewed slowly until the taste becomes strong, at this point you should stop chewing and rest the gum against the inside of your cheek. When the taste starts to fade, start chewing the gum again until the taste becomes strong once more, then rest the gum again. By doing this, each piece of gum will last for about half an hour per piece. You can tell when it is finished because the gum will no longer have any taste. After disposing of the gum hygienically you can repeat this process again the next time you feel the need to smoke.

It is best to avoid eating or drinking for 15 minutes before using, or while chewing the gum, as this can reduce the gum's effectiveness.³ It is also advisable to avoid smoking while using any form of nicotine replacement because you risk the unpleasant side effects of your body getting too much nicotine.

How successful is nicotine gum?

It has been estimated that the current level of cigarette smoking will cause about 450 million deaths worldwide in the next 50 years, and quitting is the only way to avoid this.⁴ Using nicotine gum can double your chances of giving up compared with willpower alone.¹ Highly dependent smokers (people who smoke more than 20 cigarettes a day) find that starting with 4mg nicotine gum is more effective than using 2mg gum.⁵

Is nicotine gum safe?

Nicotine gum is safe for most people who are trying to stop smoking and is available to smokers aged 18 years and over. Because studies on the safety of nicotine replacement therapy have not been carried out on people younger than 18, smokers under this age can only receive nicotine replacement products on the recommendation of a healthcare professional.

If you have a medical condition such as heart disease, an over-active thyroid gland, diabetes, severe kidney or liver disease, or stomach ulcers you should consider using nicotine replacement therapies only after having discussed the risks and benefits with your doctor. Similar advice applies if you are pregnant or breastfeeding.⁶

Are there any side-effects?

Whatever form of nicotine replacement therapy you choose, side-effects are possible. Very few people (less than 5 per cent) have to stop using nicotine replacement therapies because of side-effects.⁶ Common side-effects you may experience include:

• your tongue may tingle while chewing the gum
• you may get hiccups
• you may develop mouth ulcers, or a sore mouth
• you may have some indigestion - this is sometimes caused by chewing the gum incorrectly, and not "parking" it between your cheek and gum
• chewing can cause jaw pain. If you have problems with your jaw joint then nicotine gum may not be for you
• you may not like the taste of some nicotine gums. Both mint and citrus flavours are available, and many people find these taste better.

What are the benefits of nicotine gum?

• they are simple to use and many people find the idea of using chewing gum very acceptable
• the different strengths and flavours available of nicotine gum means that nicotine replacement therapy can be "tailored" to each individual smoker
• they provide a steady supply of nicotine
• you can readily see how much nicotine gum you are using each day
• effective.

What are the disadvantages of nicotine gum?

• some people do not like the taste
• you may not want to be seen chewing gum in public
• you may still be tempted to smoke.

Contacts/further information

Action on Smoking and Health UK (ASH)
Tel:0800 169 0169

Quitline
Tel: 0800 00 22 00

References

1. Tobacco Advisory Group of the Royal College of Physicians - Nicotine Addiction in Britain. London, Royal College of Physicians, February 2000.
2. Monthly Index of Medical Specialties. September 2002.
3. Manufacturers' advice, British National Formulary 2002.
4. Peto R, Lopez AD. The future worldwide health effects of current smoking patterns. In: Koop CE, Pearson CE, Schwarz MR,eds. Critical issues in global health. New York; Jossey-Bass (in press).
5. Lancaster T, Stead LF. Effectiveness of interventions to help people stop smoking. Cochrane Library Issue 3. Oxford Update Software 2000.
6. Guidance on the use of nicotine replacement therapy (NRT) and bupropion for smoking cessation. National Institute for Clinical Excellence, Technology Appraisal Guidance No. 39 March 2002.

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