Nicotine gum

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File:Nicorette Gum man.jpgA man about to use a piece of nicotine gum.

Nicotine gum is a type of chewing gum that delivers nicotine to the body. It is used as an aid in smoking cessation and in quitting smokeless tobacco. The nicotine is delivered to the bloodstream via absorption by the tissues of the mouth.

It is currently available over-the-counter in the US. The pieces are usually available in individual foil packages and come in various flavors including orange, and mint. Each piece typically contains 2 or 4 mg of nicotine (roughly the nicotine content of 1 or 2 cigarettes) with the appropriate dosage depending on the smoking habits of the user. Popular brands include Nicorette and Nicotinell in the UK.

Alternative nicotine replacement products include the nicotine patch, nicotine pastilles/lozenges and the nicotine inhaler.

## Contents

* 1 Usage
* 2 Availability
* 3 Risks
* 3.1 Side effects
* 4 External links
* 5 References

## Usage

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The gum is first chewed until it is soft and a tingly sensation and/or peppery taste is noticed, after which it is pressed between the cheek and gums. When the tingly sensation stops, the gum is chewed again, and then pinched between the cheek and gums in a different place in the mouth. This is continued until the gum is depleted of nicotine (about 30 minutes).

## Availability

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Various regimes exist worldwide as to the accessibility of these medications. Originally (in the early 1990s) they were sold only in the USA by prescription.

In the USA, they are currently available at drugstores over-the-counter subject to the same restrictions on underage purchases as tobacco. Usually the purchaser is directed to the pharmacist but in other cases the display of the nicotine therapy products is adjacent to the cigarette display. In some locations, nicotine gum can be simply purchased off the shelf. At locations such as large retailers, where self-checkout lines exist, the product can be purchased without human contact, thus granting the possibility of abuse by children or recreational users.

In Hong Kong, the large chain "chemist" (drugstore) shops usually, but not always, require the purchaser of the stronger therapy (4 mg dose) to sign a register with passport number or Hong Kong ID.

In Paris, the widest and least expensive variety of these aids seems to be available and while underage sales are strictly prohibited and this prohibition is enforced, sales to adults are least restricted and the largest range of alternative therapies appears to be available.

The per-dose cost in the USA is about 40 (US) cents. The per-dose cost in Hong Kong is 40 cents. This means that the price of nicotine gum often exceeds that of the cigarettes it is designed to replace, depending on the price of cigarettes in that particular locale. In counties where the price of cigarettes has been significantly augmented by progressively higher taxes, nicotine gum may in fact be a cheaper alternative. Additionally, several generic brands have appeared in recent years in much reduced cost than the nominal name brands.Nicotine is an addictive element in cigarettes. Behavioral, social, and self-image components of cigarette use also add to their addictive power. For instance, one useful technique for stopping smoking emphasises learning to concentrate on breathing differently whenever the craving for a cigarette arises. A potential for addiction to nicotine gum exists.

The drug companies' studies indicate that changing to nicotine gum leads people to quit both the gum and smoking. For many, the use of the nicotine replacement gum becomes chronic as well. Although much safer healthwise than smoking (significant evidence exists for a powerful neuroprotective effect from nicotine -alone-: e.g., a lower chance of acquiring Alzheimer's or Parkinsonian diseases), years of nicotine gum use will nevertheless still cost the addicted user many thousands of dollars.

Nicotine gum may also drive the user to "dip" tobacco because it replaces the activity of "lighting up" with a reinforced oral self-dosage, and when the nicotine gum user runs out of the gum (or cannot afford its prices, which are very high in the USA) he may turn to hazardous forms of "dip" or chewing tobacco. This is less likely to be a problem for residents of the United Kingdom where nicotine gum is also available on prescription from general practitioners, free of charge for users on low incomes and at the subsidised National Health Service prescription charge for other users.

## Risks

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### Side effects

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Two unpleasant symptoms noticed by new users and by existing users who make excessive use of the gum in times of stress[citation needed] are hiccups[1] and a perceived constriction of the throat muscles. Gum chewing is also considered uncultured in many countries; this problem can be addressed by using pastille, although the pastille is not always as available.

## External links

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* Medline Plus entry
* YourFirstStop.org

## References

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1. ↑ Einarson TR, Einarson A., "Hiccups following nicotine gum use", Ann Pharmacother., 1997 Oct;31(10):1263-4. PMID: 9337460

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