Nicorette gum

How does it work?

Nicorette gum contains nicotine. It is a type of medicine known as nicotine replacement therapy (NRT) and is used to help smokers give up the habit.

Nicotine is the addictive substance present in tobacco. Smokers who try to give up often experience unpleasant withdrawal symptoms and cravings for cigarettes, because they are dependent on the nicotine in tobacco. Withdrawal symptoms can include irritability, headaches, restlessness, insomnia and difficulty concentrating. These, combined with cigarette cravings, are why it is difficult for some people to give up smoking.

Nicotine replacement therapies work by giving you a small amount of nicotine, but without the dangerous effects of inhaling tobacco smoke. This helps relieve the withdrawal symptoms and cravings for a cigarette that you get when you stop smoking, and allows you to get on with breaking the psychological habit of smoking. If you are physically addicted to nicotine, using NRT has been shown to almost double your chances of successfully quitting smoking.

The nicotine released from chewing Nicorette gum is absorbed into the bloodstream from the lining of your mouth. For this to work, you don't chew the gum like normal chewing gum. Instead,you chew it slowly, for about a minute, until the taste becomes strong, and then rest it between your gums and your cheek. Every time the taste fades you repeat this, until the gum has lost its strength (after about half an hour).

Nicorette gum can be used to reduce your cravings for a cigarette after you have stopped smoking completely. You should chew the gum whenever you have an urge to smoke and this will help you to break the smoking habit and not start smoking again.

If you are not yet ready to stop smoking completely, Nicorette gum is also licensed to help you to cut down the number of cigarettes you smoke each day, by chewing the gum instead of having a cigarette. This can make it easier to eventually stop smoking completely. However, if you haven't managed to reduce the number of cigarettes you smoke a day within six weeks of starting to use the gum, you should ask your doctor or pharmacist for advice. You should make a quit attempt as soon as you feel ready, but not later than six months after starting to cut down using the gum. Seek advice from your doctor, pharmacist or nurse if you find this difficult.

Nicorette gum is available in two strengths. The 2mg gum is suitable for people who smoke less than 20 cigarettes a day, or whose first cigarette of the day is more than 30 minutes after waking. The 4mg gum provides a larger dose of nicotine for people who are more dependent on nicotine, ie people who smoke more than 20 cigarettes a day, or whose first cigarette is within 30 minutes of waking.

The number of pieces of gum you use each day will depend on how much you used to smoke and what strength your cigarettes were. You should not use more than is recommended on the packet.

When you quit smoking completely, it is recommended that you use the gum whenever you have a craving, for up to three months after stopping smoking. After this time your psychological urge to smoke should be less. You should then be able to gradually reduce the amount of gum you are using, so that you are using less and less nicotine. (It is rare to become dependent on the gum. If this happens it is much less dangerous than being dependent on cigarettes and is a much easier habit to break than smoking.) You should stop using the gum when your daily consumption is down to one or two pieces a day. If you use 4mg gum, the 2mg gum will be useful when you taper down use.

NRT comes in many forms. There are factsheets on all these linked at the end of this page. Nicotine patches can be used to help prevent cravings for cigarettes, while nasal sprays, inhalators, chewing gum, tablets that dissolve under the tongue, and lozenges, are all forms that can be used instead of smoking when you get a cigarette craving.

As well as breaking the physical addiction, you also need to break the smoking habits you used to have. Try to avoid situations where you will be tempted to smoke, and remember to seek help and support whenever you feel like giving in to your cravings.

What is it used for?

Relief of withdrawal symptoms associated with giving up smoking

Warning!

Nicorette gum should be chewed in the special way explained in the instructions in the package leaflet. If you chew the gum continuously, the nicotine is released too quickly and may be swallowed. This can cause side effects such as throat and stomach irritation, indigestion or hiccups.

Do not exceed the recommended dose of this medicine, which will be stated in the product packaging or information leaflet supplied with the medicine.

Acidic drinks such as coffee, sodas and fruit juices can reduce the amount of nicotine that is absorbed from the mouth if you drink them in the 15 minutes prior to chewing nicotine gum.

Smokers who wear dentures may experience problems chewing Nicorette gum. The chewing gum may stick to, and may in rare cases damage dentures. These people may find that other forms of nicotine replacement, such as nasal sprays, sublingual tablets or lozenges, are more suitable.

Make sure you do not leave unused or used Nicorette gum where children can reach it. Doses of nicotine that are tolerated by adult smokers during treatment can produce severe symptoms of poisoning in small children and may prove fatal. Dispose of Nicorette gum carefully.

Use with caution in

Adolescents aged 12 to 18 years old (If you are in this age group you should not use NRT for longer than 12 weeks without consulting a doctor, pharmacist or nurse for advice)

Disease involving the heart and blood vessels (Using NRT is much less hazardous than continuing to smoke. However, if you are in hospital because you have recently had a heart attack or stroke or you have severe irregular heart beats, you should ideally try to stop smoking without using NRT. Seek advice from your doctor.)

Diabetes (monitor your blood sugar more closely when starting NRT)

Peptic ulcer

Inflamed stomach lining (gastritis)

Inflammation of the food pipe

Inflammation of the mouth or throat

Hyperthyroidism

Tumour of the adrenal gland (phaeochromocytoma)

Severely decreased kidney function

Moderate to severely decreased liver function

Not to be used in

Non-smokers

Rare hereditary problems of fructose intolerance (Nicorette gum contains sorbitol)

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

Nicotine in any form should ideally not be used during pregnancy, as it has been shown to adversely affect the development of the baby, both in the womb and after birth. However, for pregnant women who are unable to give up smoking without a smoking cessation aid, NRT may deliver less nicotine (and none of the other potentially disease-causing agents) than would be obtained from cigarettes. As a result it is considered that NRT poses less of a risk to the foetus than continuing to smoke. Pregnant women who smoke should discuss the risks and benefits of NRT with their doctor as early as possible in their pregnancy and only use this medicine on their advice. The aim should be to stop using NRT as soon as possible, preferably after two to three months.

Nicotine taken in any form passes into breast milk and is harmful to the nursing infant. However, for women who are unable to give up smoking without a smoking cessation aid, NRT may deliver less nicotine (and none of the other potentially disease-causing agents) than would be obtained from cigarettes. It is also less hazardous than the second-hand smoke that the infant would be exposed to if the mother continued to smoke. This medicine can therefore be used during breastfeeding. Wherever possible, the gum should be chewed immediately after breastfeeding and not in the two hours before breastfeeding, in order to reduce the amount of nicotine that the infant is exposed to.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Sore mouth or throat

Throat irritation

Increased salivation

Hiccups

Dizziness

Headache

Nausea

Heartburn or indigestion (slower chewing or using 2mg gum may reduce this problem)

Jaw ache

Awareness of your heartbeat (palpitations)

Mouth ulcers

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

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