Nicotine gum
Encyclopedia
Chewing gum
Chewing gum is a type of gum traditionally made of chicle, a natural latex product, or synthetic rubber known as polyisobutylene. For economical and quality reasons, many modern chewing gums use rubber instead of chicle...
that delivers nicotine
Nicotine
Nicotine is an alkaloid found in the nightshade family of plants that constitutes approximately 0.6–3.0% of the dry weight of tobacco, with biosynthesis taking place in the roots and accumulation occurring in the leaves...
to the body. It is used as an aid in nicotine replacement therapy
Nicotine replacement therapy
Nicotine replacement therapy is the remedial administration of nicotine to the body by means other than tobacco, usually as part of smoking cessation. Common forms of nicotine replacement therapy are nicotine patches and nicotine gum...
(NRT), a process for smoking cessation
Smoking cessation
Smoking cessation is the process of discontinuing the practice of inhaling a smoked substance. This article focuses exclusively on cessation of tobacco smoking; however, the methods described may apply to cessation of smoking other substances that can be difficult to stop using due to the...
and quitting smokeless tobacco
Dipping tobacco
Dipping tobacco, traditionally referred to as moist snuff, is a type of finely ground or shredded, moistened smokeless tobacco product. It is commonly and idiomatically known by various terms – most often as dip and sometimes rub or chew...
. The nicotine is delivered to the bloodstream via absorption by the tissues of the mouth.
It is currently available over-the-counter
Over-the-counter drug
Over-the-counter drugs are medicines that may be sold directly to a consumer without a prescription from a healthcare professional, as compared to prescription drugs, which may be sold only to consumers possessing a valid prescription...
in Europe, the US and elsewhere. The pieces are usually available in individual foil packages and come in various flavors. Nicotine content is usually either 2 or 4 mg of nicotine, roughly the nicotine content of 1 or 2 cigarettes, with the appropriate content and dosage depending on the smoking habits of the user. Popular brands include Nicoderm
Nicoderm
NicoDerm, also known as NicoDerm CQ is a branded over the counter palliative nicotine replacement therapy used to minimize the withdrawal effects involved in quitting smoking....
/Nicorette
Nicorette
Nicorette is the brand name of a pharmaceutical preparation that contains nicotine for the treatment of tobacco dependence. Nicorette was the first medicinal preparation to facilitate smoking cessation....
, Nicogum and Nicotinell.
Alternative nicotine replacement products include the nicotine patch
Nicotine patch
A nicotine patch is a transdermal patch that releases nicotine into the body through the skin. It is used as an aid in nicotine replacement therapy , a process for smoking cessation. The first published study of the pharmacokinetics of a transdermal nicotine patch in humans was authored by Jed E....
, nicotine pastilles/lozenges
Nicotine lozenge
A nicotine lozenge is a tablet that contains a dose of nicotine which dissolves slowly in the mouth to release the nicotine. The nicotine is absorbed through the lining of the mouth and enters the blood vessels...
and the nicotine inhaler.
Usage
Gum should not be used less than 15 minutes after eating or drinking, as this will reduce absorption. Users are directed to chew the gum until it softens and produces a tingling sensation or "peppery" taste. The gum is then "parked," or tucked, in between the cheek and gums. When the tingling ends the gum is chewed again until it returns, and is then re-parked in a new location. These steps are repeated until the gum is depleted of nicotine (about 30 minutes) or the craving dissipates. Dosage suggested by the Dental-professional.com website is: weeks 1-6: 1 piece every 1 to 2 hours; weeks 7-9: 1 piece every 2 to 4 hours; weeks 10-12: 1 piece every 4–8 hours; no more than 24 pieces per day. Do not use for longer than 12 weeks. Pregnant women should neither smoke nor use NRT. Light smokers should use the 2 mg and heavy smokers the 4 mg; dosage is the same for both sizes.When used properly, about 3 mg is absorbed into the bloodstream from the 4 mg gum, and 1 mg from the 2 mg gum.
Availability
Various policies exist worldwide as to the accessibility of these medications. Originally (in the 1980s) gum was sold only by prescription.In most of the EU and the USA, nicotine gum is available at pharmacies
Pharmacy
Pharmacy is the health profession that links the health sciences with the chemical sciences and it is charged with ensuring the safe and effective use of pharmaceutical drugs...
over-the-counter subject to the same restrictions on underage purchases as tobacco
Tobacco
Tobacco is an agricultural product processed from the leaves of plants in the genus Nicotiana. It can be consumed, used as a pesticide and, in the form of nicotine tartrate, used in some medicines...
. Depending upon jurisdiction and pharmacy the purchaser may be directed to the pharmacist
Pharmacist
Pharmacists are allied health professionals who practice in pharmacy, the field of health sciences focusing on safe and effective medication use...
, or nicotine gum may be purchased off-the-shelf. If sold where tobacco products are also sold, the display of the nicotine therapy products may be adjacent to the tobacco display.
In New Zealand (and now Australia) nicotine gum and patches are classified as General Sale and can be sold in outlets other than pharmacies, e.g. petrol stations and supermarkets. This has resulted in a steep fall in the retail price, particularly from online New Zealand stores.
This trend away from only being sold over the counter (S3) at pharmacies also followed in Australia with sharp price falls in the last year[ref=2010] and wide availability. Nicotine gum, lozenges and similar preparations can be now readily found on the shelf in the medicinal aisle of most major chain supermarkets and can be purchased alongside other grocery items.
In the United Kingdom many NRT products are available in shops, supermarkets, petrol stations and even schools, although an age limit of 12 is required. Own-brand NRT products are available from some pharmacy chains. The National Health Service
National Health Service
The National Health Service is the shared name of three of the four publicly funded healthcare systems in the United Kingdom. They provide a comprehensive range of health services, the vast majority of which are free at the point of use to residents of the United Kingdom...
(NHS) provides NRT at a discounted price or free of charge.
In Hong Kong
Hong Kong
Hong Kong is one of two Special Administrative Regions of the People's Republic of China , the other being Macau. A city-state situated on China's south coast and enclosed by the Pearl River Delta and South China Sea, it is renowned for its expansive skyline and deep natural harbour...
the large chain pharmacist 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.
Health effects of nicotine
NicotineNicotine
Nicotine is an alkaloid found in the nightshade family of plants that constitutes approximately 0.6–3.0% of the dry weight of tobacco, with biosynthesis taking place in the roots and accumulation occurring in the leaves...
is a vasoconstrictor; it constricts arteries, making it harder for the heart
Heart
The heart is a myogenic muscular organ found in all animals with a circulatory system , that is responsible for pumping blood throughout the blood vessels by repeated, rhythmic contractions...
to pump
Pump
A pump is a device used to move fluids, such as liquids, gases or slurries.A pump displaces a volume by physical or mechanical action. Pumps fall into three major groups: direct lift, displacement, and gravity pumps...
blood
Blood
Blood is a specialized bodily fluid in animals that delivers necessary substances such as nutrients and oxygen to the cells and transports metabolic waste products away from those same cells....
through the body
Body
With regard to living things, a body is the physical body of an individual. "Body" often is used in connection with appearance, health issues and death...
. Repeated nicotine exposure contributes to accelerated coronary artery disease, acute cardiac ischemic events, and hypertension
Hypertension
Hypertension or high blood pressure is a cardiac chronic medical condition in which the systemic arterial blood pressure is elevated. What that means is that the heart is having to work harder than it should to pump the blood around the body. Blood pressure involves two measurements, systolic and...
Additionally, studies have shown that nicotine exposure contributes to stroke
Stroke
A stroke, previously known medically as a cerebrovascular accident , is the rapidly developing loss of brain function due to disturbance in the blood supply to the brain. This can be due to ischemia caused by blockage , or a hemorrhage...
, peptic ulcer disease, and esophageal reflux. Further, nicotine may cause wounds to heal more slowly and may be associated with reproductive toxicity. Moreover, nicotine can cause the body to release its stores of fat and cholesterol into the blood.
Nicotine replacement therapies, such as nicotine gum, that were used for long periods of time may be associated with an increased risk of contracting oral cancer among people who have a specific gene mutation in their mouth, according to a study done at University of London.
Muscle control
Two unpleasant symptoms which affect some new users, and existing users who make excessive use of nicotine gum, are hiccupHiccup
A hiccup or hiccough is a myoclonus of the diaphragm that repeats several times per minute. In humans, the abrupt rush of air into the lungs causes the vocal cords to close, creating a "hic" sound....
s and a perceived constriction of the throat
Throat
In vertebrate anatomy, the throat is the anterior part of the neck, in front of the vertebral column. It consists of the pharynx and larynx...
muscles, as accidental swallowing of saliva containing high amounts of nicotine may cause irritation.