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Nicotine Gum

A physician's prescription used to be required to obtain the gum, but in 1996 the gum became an over-the-counter (OTC) medication. Nicorette is the brand name but there are generic forms of the gum. The manufacturer states that Nicorette allows smokers to self-titrate (up to 24 pieces a day) and it is currently available in six different flavors. The gum allows the nicotine to be absorbed through the mucus membranes of the mouth between the cheek and the gums. It comes in a 4 milligram (mg) dose for those patients who smoke more than 25 cigarettes a day, and a 2 mg dose for those who smoke less than 25 cigarettes a day.

One piece of nicotine gum is chewed every one to two hours at first, or it may be chewed when you have the urge to smoke. Chew slowly until you can taste the nicotine or feel a slight tingling in your mouth. Then stop chewing and place (park) the gum between your cheek and gum. When the tingling sensation is almost gone (about 1 minute), start chewing again. Repeat this procedure for about 30 minutes. Do not chew more than one piece of gum at a time, and do not chew one piece after another. Gradually reduce the amount of nicotine gum after two to three months. Reducing the use of nicotine gum over time will help prevent withdrawal symptoms.

Tips to help reduce the use of nicotine gum gradually include:

Decrease the total number of pieces used per day by about one piece every four to seven days.

Decrease the chewing time with each piece from the normal 30 minutes to 10 to 15 minutes for 4 to 7 days. Then gradually decrease the total number of pieces per day.

Substitute pieces of nicotine gum with one or more pieces of sugarless gum for an equal number. Every four to seven days, increase the number of sugarless gum pieces as substitutes for nicotine gum.

Replace the 4-mg gum with the 2-mg gum and apply the previous steps.

Consider stopping use of nicotine gum when your craving for nicotine is satisfied by one or two pieces of gum per day.

The Nicotine Patch

The patch comes in four main brands: Nicotrol, Nicoderm, Prostep, and Habitrol. All four patches transmit low doses of nicotine to the body throughout the day. Other smoking cessation programs or materials should be used while using the patch.

The Nicoderm patch offers a three-step program that can be used for 16 to 24 hours each day. One patch contains 21 mg of nicotine and is recommended for patients who smoke more than 10 cigarettes per day. Another patch contains 14 mg of nicotine and is recommended for patients who smoke less than 10 cigarettes per day. Apply the patch directly to the skin once a day, usually at the same time of day. Apply the patch to a clean, dry, hairless area of skin on the upper chest, upper arm, or hip, as specified by the package directions. Remove the patch from the package, peel off the protected strip, and immediately apply the patch to your skin. The sticky side should touch the skin. Press the patch to the skin by placing the palm of your hand over it for about 10 seconds. Be sure the patch is held firmly in place, especially around the edges. Wash your hands with water only after applying the patch. If the patch falls off or loosens, replace it with a new one. Wear the patch continuously for 16 to 24 hours. The patch may be worn even while showering or bathing. Remove the patch carefully, and dispose of it by folding it in half with the sticky sides touching. After removing the patch, apply the next patch to a different skin area to prevent skin irritation. Nicotine patches may be used from 6 to 20 weeks. A switch to a lower strength patch may be considered after the first two weeks. A gradual reduction to a lower dosage of the patch is recommended so that the amount of nicotine in the system is reduced and consequently, the nicotine withdrawal symptoms will be reduced.

 
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