Smoking and Quitting Smoking (cont.)
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- Smoking and quitting smoking facts
- What problems are caused by smoking?
- What are the symptoms and signs of cigarette addiction?
- What are the steps in quitting?
- Getting ready to quit smoking
- On the day you quit smoking
- Staying quit
- What methods can help a person quit smoking?
- Nicotine replacement therapy to quit smoking
- Nicotine patches
- Nicorette gum
- Nicotine lozenges
- What prescription products are available for smoking cessation?
- How can nicotine-containing products be used safely?
- What are e-cigarettes?
- Is an e-cigarette harmful?
- Is secondhand smoke from e-cigarettes harmful?
- What is in the future for smoking?
- Smoking FAQs
- Find a local Internist in your town
The gum, Nicorette, is available in a variety of flavors in 2 strengths; 4 and 2 mg. Patients are advised to begin with the 4 mg piece of gum if they smoke more than 25 cigarettes per day or the 2 mg piece if they smoke fewer than 7 cigarettes per day. No more than 20 pieces of the 4 mg strength or 30 pieces of the 2 mg strength should be chewed in one day. Initial weaning from treatment should begin after 2 to 3 months and be completed by 4 to 6 months. The most common side effects with Nicorette gum are:
- aching jaws or soreness of the gums,
- changes in taste,
- abdominal (gastrointestinal) discomfort,
- vomiting, and
Commit nicotine lozenges are available in 2 or 4 mg doses. One dose consists of one lozenge, and no more than 20 doses should be consumed in one day. The manufacturers of Commit recommend choosing the proper dosage based upon when you usually have the first cigarette of your day. According to the manufacturer's instructions, if you smoke within 30 minutes of getting up in the morning, you should use the stronger 4 mg dose. If not, you should use the 2 mg lozenges.
Biting or chewing nicotine lozenges instead of allowing them to dissolve can lead to indigestion or heartburn. You should not eat or drink anything while the lozenge is in your mouth. The lozenges will last for about 20-30 minutes when allowed to dissolve in the mouth. The most commonly reported side effects with nicotine lozenges are:
- throat irritation,
- soreness of the teeth or gums,
- headache, and
How effective is nicotine replacement therapy?
Approximately 25% of patients successfully stop smoking with nicotine patch therapy. The success rate with nicotine gum is similar. There have not yet been studies to compare the effectiveness of nicotine lozenges to the patch or gum. The rate of success for nicotine replacement therapy increases 35% to 40% when intensive behavioral counseling is added.
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