Harmful Effects of Nicotine Gum as a Stimulant
Using nicotine gum as a stimulant rather than for smoking cessation carries significant cardiovascular risks including increased blood pressure, heart rate, and narrowing of arteries, with minimal evidence supporting positive cognitive effects.
Cardiovascular Effects
Nicotine, even in the form of nicotine replacement therapy (NRT) gum, has several documented cardiovascular effects:
- Increases blood pressure and heart rate 1
- Increases blood flow to the heart 1
- Causes narrowing of the arteries 1
- May contribute to hardening of arterial walls, potentially leading to heart attacks 1
- In healthy non-smokers, nicotine gum (4mg) has been shown to increase heart rate by 10-12% 2
Toxicity and Overdose Risk
Using nicotine gum as a stimulant rather than for smoking cessation increases the risk of overdose:
- The FDA-approved dosing is specific to smoking cessation, with a maximum of 24 pieces per day 3
- Exceeding recommended doses can lead to serious adverse effects
- Case reports document severe toxicity, including one case of respiratory failure requiring mechanical ventilation after consuming excessive amounts of nicotine gum 4
- The lethal dose of nicotine is estimated at 30-60 mg 4, which could potentially be reached with improper use
Common Side Effects
When used as directed, nicotine gum commonly causes:
- Jaw fatigue and soreness 1
- Hiccupping and burping 1
- Nausea 1
- In non-smokers or with excessive use: nausea, dizziness, and anxiety 2
Dependence Risk
While the risk of developing dependence on nicotine gum is lower than with cigarettes 1, 5, it still contains nicotine, which is the primary addictive substance in tobacco products 1. Using it as a stimulant rather than for smoking cessation may increase the risk of dependence.
Potential Positive Effects
There is limited evidence regarding positive effects of nicotine:
- Nicotine is a breathing stimulant that increases muscle activity and dilates the upper airway 1
- One study found that nicotine gum at bedtime prevented obstructive sleep apnea in the first 2 hours of sleep, though two subsequent randomized controlled trials found no effect 1
- Nicotine has both stimulant and depressant properties, affecting the central nervous system, peripheral nervous system, cardiovascular system, and gastrointestinal systems 6
Conclusion
The evidence strongly suggests that using nicotine gum as a stimulant carries significant cardiovascular risks with minimal proven benefits. The FDA-approved labeling specifically indicates nicotine gum should be used only for smoking cessation according to a specific dosing schedule 3. While the risks may be lower than smoking cigarettes 7, using nicotine gum for non-approved purposes introduces unnecessary health risks, particularly to the cardiovascular system.
For those seeking cognitive enhancement or stimulation, safer alternatives with better evidence profiles should be considered instead of misusing nicotine replacement therapy products.