Various brands (Nicobate, Nicorette, Nicotrol, Quitex, generics)
Available over-the-counter for smoking cessation.
Delivers nicotine orally, eliminating any exposure of carcinogens to the lungs
Supplied as 2 mg or 4 mg pieces of gum.
Heavier smokers should start with the 4 mg dose, lighter smokers with the 2 mg dose. Directions are to chew one piece every hour as needed for urges to smoke. Not to exceed 30 pieces per day of the 2 mg or 24 per day of the 4 mg dose.
Price varies depending on brand and pharmacy, but a month-long course costs around $100.00.
Tips for patients: Chew slowly until you feel a “tingling” or “peppery taste” (indicating release of nicotine), then park the gum between cheek and gum. When tingling stops, chew again until tingling, park it, and so on. One piece may last 30 minutes.
Quit rates about 20% after one year, or double the rate of placebo.
Symptoms of nicotine intoxication possible (especially if patients smoke while using the gum), including dizziness, nausea, diarrhea.
Since nicotine induces the metabolism of clozapine, Zyprexa (olanzapine), and caffeine, quitting smoking may cause a rise in levels of these compounds, necessitating a lower dosage.
Continuously released while chewing.