How can nicotine gum be used to help quit smoking?

Using Nicotine Gum for Smoking Cessation

Nicotine gum is an effective smoking cessation aid that approximately doubles cessation rates compared to placebo, with efficacy rates of 5-8% above control groups depending on the intensity of behavioral support provided. 1

How to Use Nicotine Gum

Dosage Selection

• For smokers who have their first cigarette within 30 minutes of waking: Use 4mg nicotine gum 2
• For smokers who have their first cigarette more than 30 minutes after waking: Use 2mg nicotine gum 2

Proper Usage Instructions

1. Chew the gum slowly until you notice a peppery/minty taste or slight tingling sensation
2. Park the gum between your cheek and gums when you feel this sensation
3. When the sensation fades (about 1 minute), chew again until the sensation returns
4. Repeat this "chew and park" process for about 30 minutes per piece
5. Use at least 9 pieces per day during the first six weeks 2
6. Continue for the full 12-week program to maximize success 2

Recommended Schedule

• Weeks 1-6: Chew one piece every 1-2 hours (at least 9 pieces daily)
• Weeks 7-9: Chew one piece every 2-4 hours
• Weeks 10-12: Chew one piece every 4-8 hours

Effectiveness and Evidence

Nicotine gum works by:

• Providing controlled amounts of nicotine to reduce cravings
• Managing withdrawal symptoms (irritability, depression, anxiety)
• Allowing the smoker to gradually reduce nicotine dependence 3

The effectiveness varies based on:

• Intensity of behavioral support: Higher success rates (8%) with intensive behavioral support versus limited support (5%) 1
• Dosage: 4mg gum is more effective for heavy smokers than 2mg 3
• Proper usage: Correct "chew and park" technique ensures proper nicotine absorption through the mouth lining rather than swallowing it 1

Enhancing Success Rates

1. Combine with behavioral support:

   • Group sessions focusing on mutual support rather than didactic input 1
   • Individual counseling that includes coping skills training 1
   • At least five sessions of about one hour over one month, plus follow-up 1

2. Consider combination therapy:

   • Combining nicotine patch with gum can increase quit rates over single therapy 4, 5
   • This approach provides steady background nicotine levels (patch) plus on-demand relief for breakthrough cravings (gum)

3. Use carbon monoxide monitoring:

   • Measuring CO levels at follow-up sessions provides objective feedback and motivation 1

Common Side Effects and Management

• Jaw fatigue/soreness: Ensure proper "chew and park" technique
• Hiccups/burping: Slow down chewing pace
• Nausea: Common side effect, especially with incorrect technique (swallowing nicotine)
• Mouth irritation: May resolve with continued use 3

Special Populations

• Pregnant women: Generally contraindicated, though risk-benefit analysis may be considered in heavy smokers unable to quit by other means 1, 3
• Cardiovascular disease patients: Use with caution; however, benefits may outweigh risks compared to continued smoking 1
• Young people under 18: Not recommended 3

Common Pitfalls to Avoid

1. Insufficient dosage: Many smokers don't use enough gum (minimum 9 pieces daily in first 6 weeks) 2
2. Incorrect chewing technique: Chewing continuously like regular gum reduces effectiveness and increases side effects
3. Stopping too soon: The full 12-week program significantly improves success rates 2
4. Using as occasional substitute: Gum should be used as part of a complete cessation program, not just when unable to smoke
5. Drinking acidic beverages: Avoid coffee, juice, and soft drinks 15 minutes before and during gum use as they reduce nicotine absorption

Nicotine gum is a proven, effective tool for smoking cessation when used correctly as part of a comprehensive quit plan that includes behavioral support. Success rates are highest when proper technique, adequate dosage, and sufficient duration of treatment are followed.