Why Nicotine Gum Must Be Chewed and Parked
Nicotine gum must be chewed slowly and then parked between the cheek and gum because nicotine is absorbed through the oral mucosa, not through swallowing—any nicotine that is swallowed is wasted and does not contribute to smoking cessation. 1
The Chew-and-Park Technique Explained
The FDA-approved method requires a specific technique to maximize nicotine absorption and therapeutic benefit:
- Chew slowly until you feel a tingling sensation, then immediately stop chewing and park the gum between your cheek and gum 2
- When the tingle disappears, resume chewing until the tingle returns, then park again 2
- Repeat this chew-and-park cycle for approximately 30 minutes until most of the tingle is gone 2
Why This Technique Is Critical
Absorption Mechanism
- Nicotine must be absorbed through the buccal mucosa (mouth lining) to enter the bloodstream effectively 1
- Swallowed nicotine is metabolized by the liver before reaching systemic circulation, rendering it therapeutically ineffective 1
- The "parking" phase allows nicotine to be absorbed directly through the oral mucosa into the bloodstream 1
Pharmacokinetic Profile
- Proper chewing technique produces steady-state plasma nicotine levels of 11.8 ng/mL with 2 mg gum and 23.2 ng/mL with 4 mg gum when used hourly 3
- These levels are comparable to the trough levels seen in regular smokers (15.7-18.3 ng/mL), providing adequate nicotine replacement without the harmful tar and carbon monoxide from cigarettes 3
- NRT delivers nicotine more slowly than smoking, with more gradual increases in blood levels, which reduces addictive potential while still managing withdrawal symptoms 4
Common Pitfalls to Avoid
Incorrect Chewing Technique
- Do not chew continuously like regular gum—this causes excessive nicotine to be swallowed rather than absorbed, leading to hiccups, heartburn, nausea, and reduced efficacy 2
- Do not eat or drink for 15 minutes before or during gum use—acidic beverages and food can interfere with nicotine absorption through the oral mucosa 2
Inadequate Dosing
- Heavy smokers should use 4 mg gum (those who smoke their first cigarette within 30 minutes of waking) 2
- Use at least 9 pieces per day for the first 6 weeks to maintain adequate nicotine levels and control withdrawal symptoms 2
- Do not use more than 24 pieces per day to avoid nicotine toxicity 2
Treatment Duration and Success
- Follow the 12-week tapering schedule: Weeks 1-6 use one piece every 1-2 hours, Weeks 7-9 every 2-4 hours, Weeks 10-12 every 4-8 hours 2
- Combination therapy (patch plus gum) nearly doubles quit rates compared to patch alone, achieving 36.5% abstinence at 6 months versus 23.4% for monotherapy 5
- Very few people become addicted to NRT itself—most long-term users continue due to fear of relapse, and 65% can successfully discontinue after extended use 6