What You Need to Know About Nicotine Gum – Smoking Cessation Center

Seventy-four percent of Americans who smoke say they would like to give it up, and 67 percent of smokers believe they are addicted to cigarettes, according to a Gallup poll. Although quitting can be a challenge, there are a number of methods that have been proven to help, including medication and counseling.

Many people who want to stop smoking turn to nicotine gum, which research shows can be helpful for smokers who are trying to quit but are struggling with nicotine withdrawal. It was the first nicotine replacement therapy to be approved for over-the-counter sale by the U.S. Food and Drug Administration, which gave it the nod back in February 1996, months before nicotine patches were approved for non-prescription use.

A Look at Nicotine Gum Choices

Nicotine gum is available under the brand names Nicorette and Nicorette DS. Generic forms of nicotine polacrilex gum are available, under names such as Habitrol, Nicotrol, and Prostep.

The gum comes in dosages of 2 and 4 milligrams (mg). You can purchase nicotine gum at most drug stores, grocery stores, and department stores. On average you’ll spend $4.50 for 10 pieces of gum, the amount most people need to chew daily to control nicotine withdrawal.

How You Use Nicotine Gum

You don’t chew nicotine gum the way you chew normal gum. If you did, all the nicotine would be released directly into your saliva. If you swallowed the nicotine-soaked saliva, it would provoke a terrible stomachache and a nasty and overwhelming craving for a cigarette.

Instead, you use a method called “chew-and-park”:

• Chew the gum slowly a few times to break it down, until you sense a peppery taste or note a tingling in your mouth.
• Then park it between your cheek and gum, as you would chewing tobacco. The nicotine will pass through the lining of your mouth into your bloodstream, providing you with a hit of nicotine that reaches your brain in a matter of minutes.
• When the tingling or peppery taste subsides, in about one minute, repeat the chewing and parking process.
• Continue to chew and park the gum for about 20 to 30 minutes; at that point you will have absorbed all the nicotine.

How Much Nicotine Gum to Chew

People who smoke 24 or fewer cigarettes per day should use the 2 mg dosage. Smokers of 25 or more cigarettes daily should use the 4 mg dosage. You might also want to consider the higher dose if you crave a cigarette within a half-hour of waking up or find it hard not to smoke in restricted areas. Each piece of gum is one dose, and you should not chew more than 24 pieces a day. After two or three months, you should begin tapering off the amount of gum you chew each day.

An important point to remember: What you eat and drink will affect how you absorb the nicotine from gum. Avoid acidic substances like coffee, soft drinks, and juices for at least 15 minutes prior to and during gum use.

The Pros and Cons of Nicotine Gum

Nicotine gum has several advantages over the nicotine patch:

• The smoker controls the dosage and can pop a piece of nicotine gum to help deal with a particularly bad craving.
• The nicotine is more quickly absorbed into the body than nicotine in a patch, providing quicker relief.

However, there are several drawbacks to nicotine gum:

• If you swallow the gum or use it improperly, you could have hiccups, dizziness, nausea, or upset stomach.
• You could end up getting hooked on the nicotine gum. Studies have found that 15 to 20 percent of smokers who use nicotine gum to successfully quit keep using the gum for a year or longer. Most doctors want you to limit your use of nicotine gum to six months, although it’s likely that even if you continue beyond that point, using the gum is still safer than going back to smoking.
• Pregnant women should not use nicotine gum because the nicotine could harm the fetus.

Do not smoke while using the gum or you could end up with a nicotine overdose. You should talk with your doctor before using nicotine gum if you’ve ever had heart problems, high blood pressure, ulcers, an overactive thyroid, or dentures or some other types of dental work.

Nicotine gum may offer the help you need to quit smoking. As long as you use it correctly, you might achieve the success you’ve been hoping for.

Nicotine Gum | Michigan Medicine

Topic Overview

You chew nicotine gum as a way to help yourself quit using tobacco. The gum contains nicotine and feels and looks like chewing gum. When you chew the gum, the nicotine begins to slowly release into your mouth. Then you hold the gum in your mouth between your cheek and gums.

Cigarette smoke passes nicotine almost instantly into the blood through the lining of the lungs, and the blood takes it to the brain in a few seconds. The nicotine in the gum takes several minutes to reach the brain. This makes the “hit” less rapid with the gum than with a cigarette. Nicotine gum also delivers much less nicotine to your body than a cigarette would.

How to use nicotine gum

Nicotine gum comes in several flavors and in two strengths: 2 mg and 4 mg. Start with the 4 mg strength if you smoke 25 or more cigarettes a day or if your doctor recommends it.

Do not chew nicotine gum like normal gum. Instead, use the “chew and park” method:

• Use one piece of gum at a time.
• Put a piece of gum into your mouth, and chew it slowly a few times to break it down. Chewing will release a “peppery” taste. Next, park the gum between your gums and cheek, and leave it there.
• Repeat the process of chewing and parking for about 15 to 30 minutes, or until there is no more peppery taste released by chewing. The gum is used up at that point. The nicotine from the gum makes its way into your system through the blood vessels that line your mouth.
• If you chew the gum without parking it, the nicotine will be released directly into the saliva in your mouth and you will swallow it. This may cause a stomachache, hiccups, or heartburn. Also, it may take longer for the nicotine to get into your bloodstream.

Other tips for using nicotine gum

• Avoid drinking beverages, especially acidic ones (such as coffee, juices, and soda pop), for 15 minutes before and after you chew. Your body may not absorb the nicotine well because of the acid in these drinks.
• Follow the written instructions that come with the gum for how many pieces you can use per day. Most people use 10 to 15 pieces a day. (Do not chew more than 30 pieces of the 2 mg gum or 20 pieces of the 4 mg gum a day.)
• Consider using the other materials provided with the nicotine gum. These can help you change your smoking behavior.
• Avoid the common mistakes of chewing too little gum or stopping use too early. Using too little of the gum will result in withdrawal symptoms similar to those caused by abruptly stopping smoking.
• As the urge to smoke decreases, use fewer pieces of gum each day. When you are using only 1 or 2 pieces a day, stop using the gum completely. However, you may want to keep some nicotine gum with you in case you find yourself in a potential relapse situation.

It is possible to become dependent on nicotine gum, but this is rare.

Nicotine gum does have side effects. Read the package insert before you use this medicine.

Credits

Current as of:
March 12, 2020

Author: Healthwise Staff
Medical Review:
Adam Husney MD – Family Medicine
Kathleen Romito MD – Family Medicine
Michael F. Bierer MD – Internal Medicine, Addiction Medicine

Current as of: March 12, 2020

Author:
Healthwise Staff

Medical Review:Adam Husney MD – Family Medicine & Kathleen Romito MD – Family Medicine & Michael F. Bierer MD – Internal Medicine, Addiction Medicine

Nicotine Gum Dosing | Using Nicorette® Gum

If you smoke your first cigarette within 30 minutes of waking up, use Nicorette® 4mg nicotine gum.

If you smoke your first cigarette more than 30 minutes after waking up, use Nicorette® 2mg nicotine gum.

Read on to find out about nicotine gum dosing*, and where to buy Nicorette^® Gum.

*Dosage schedule based on whether users smoke their first cigarette later than (2mg), or within (4mg), 30 minutes after waking. If you experience strong or frequent cravings, you may use a second piece within the hour. However, do not continuously use one piece after another since this may cause you hiccups, heartburn, nausea or other side effects.

To improve your chances of quitting smoking, use at least 9 pieces a day for the first 6 weeks..^i.

Do not chew more than 24 pieces a day.^i.

It is essential to complete the treatment. If you feel you need to use the gum for a longer period to keep from smoking, talk to your healthcare provider.

Nicotine gum is a medicine and must be used in a certain way to get the best results. Always read and follow label directions. Behavioral support program increases chances of success.

The FDA has concluded that there are no significant safety concerns associated with using more than one over-the-counter (OTC) nicotine replacement therapy (NRT) at the same time, or using an OTC NRT at the same time as another nicotine-containing product— including a cigarette. If you are using an OTC NRT while trying to quit smoking but slip up and have a cigarette, you should not stop using the NRT. You should keep using the OTC NRT and keep trying to quit.

SOURCES

^{i. Nicotine gum. Medline Plus. https://medlineplus.gov/druginfo/meds/a684056.html. Accessed 13/12/19.}

Using the Nicotine Patch, Nicotine Gum, Nicotine Nasal Spray or Nicotine Inhaler

Please note: This information was current at the time of publication. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit familydoctor.org, the AAFP patient education website.

Information from Your Family Doctor

Am Fam Physician. 2001 Jun 1;63(11):2251-2252.

When you are ready to quit smoking, you may want to use nicotine replacement therapy to help you give up cigarettes. The cost of nicotine replacement therapy is about the same or less than the cost of cigarettes.

The nicotine patch, gum, nasal spray and inhaler are all forms of nicotine replacement therapy. All forms of nicotine replacement can help lessen your urge to smoke. This means you have less craving for nicotine when you stop smoking. You may still feel a craving to smoke, but don’t smoke while using the patch, gum, nasal spray or inhaler.

Who should use nicotine replacement therapy?

Almost every smoker can benefit from using nicotine replacement therapy. If you are pregnant or if you have heart or blood vessel problems, your doctor will be careful about giving you the nicotine patch or gum.

How do I know what strength is right for me?

Patch

Most smokers should start using a full-strength patch (15 to 22 mg of nicotine) every day for 4 weeks and then a weaker patch (5 to 14 mg of nicotine) for another 4 weeks.

Gum

Many smokers should start using the 2-mg dose. However, you may want to start with 4-mg gum if you:

• Smoke more than 20 cigarettes a day.

• Smoke as soon as you wake up in the morning.

• Have severe withdrawal symptoms when you don’t smoke.

• Have tried to quit on a lower dose and failed.

If you are a very light smoker (less than 10 to 15 cigarettes a day) or have health problems, your doctor can help you select the right dose.

Should I use the nicotine patch, gum, nasal spray or inhaler?

Any of these treatments can help once you are ready to quit. The choice is up to you. Some people don’t like the taste of the gum or don’t like chewing in public. They prefer the patch. Other people have been unable to quit on the patch and want to try the gum. Some people prefer to use a nasal spray and some prefer the inhaler. Using the nicotine patch, gum, nasal spray or inhaler almost doubles your chances of quitting. Here is some information to help you decide which one is right for you.

Nicotine Patch

Directions for use

At the start of each day, place a new patch on a part of your body between the neck and the waist. Put the patch on a new spot each day to lessen skin irritation.

Treatment period

The patch is usually used for up to 8 weeks.

Side effects

Some people who use the patch get a rash on their body where the patch is placed. Skin rashes are usually mild and easily treated. Moving the patch to another area of the body helps.

If you have any side effects from the patch, be sure to tell your doctor right away.

How to get the patch

You can buy the patch without a doctor’s prescription. To be safe, carefully read and follow the directions inside the package. You can talk to your doctor about how to use it and how long to use it.

Nicotine Gum

Directions for use

The gum must be chewed in a special way to make it work. Chew it slowly until you notice a “peppery” taste. Then stop chewing and move the nicotine gum between your cheek and your gum. Each piece of nicotine gum should be kept in your mouth for about 30 minutes.

Treatment period

A regular schedule (at least one piece of nicotine gum every 1 to 2 hours for 1 to 3 months) may give the best results. Some people don’t chew enough pieces of gum a day and or they don’t chew the gum for 8 weeks. They might not get the most benefit from nicotine gum.

Side effects

Some people have mild side effects such as hiccups, upset stomach or sore jaws. Most of these side effects go away if the gum is used correctly.

If you have any side effects from the gum, be sure to tell your doctor right away.

How to get nicotine gum

You can buy the gum without a doctor’s prescription. To be safe, carefully read and follow the directions inside the package. Also, you can talk to your doctor about how to use it and how long to use it.

Nicotine Nasal (nose) Spray

Directions for use

Apply one spray in each nostril. Use the spray one to two times each hour while you are awake. Use the spray at least 8 times a day. Don’t use it more than 40 times a day.

Side Effects

The nasal spray may cause nasal irritation, diarrhea and a fast heart rate. If you have hay fever or sinus infection, ask your doctor about using one of the other forms of nicotine replacement therapy.

If you have any side effects from the nasal spray, be sure to tell your doctor right away.

How to get the nasal spray

You can only get the nasal spray with a doctor’s prescription. To be safe, carefully read and follow the directions inside the package.

[
corrected] Nicotine Inhaler

Directions for use

Inhale from a cartridge when you have a desire for a cigarette. Use no more than 16 cartridges a day for up to 12 weeks.

Side Effects

You might have irritation of throat and mouth when you first start to use the inhaler. It might make you cough. You should get over this after a while.

If you have any side effects from the inhaler, be sure to tell your doctor right away.

How to get the inhaler

You can only get the nicotine inhaler with a doctor’s prescription. To be safe, carefully read and follow directions inside the package.

Recommending nicotine replacement therapy – Portico

Rationale for recommending the NRT patch

The goal in recommending the patch is to meet patients’ nicotine needs, allowing them to feel, for the most part, comfortable throughout the day.

By providing relief from the symptoms of nicotine withdrawal, NRT makes it easier for patients to focus on making behavioural changes in their lives.

The patch will not treat sudden cravings or urges caused by environmental or emotional cues.

The patch also will not make someone quit – it is not a substitute for motivation. However, if used in the appropriate dose, the patch will make the process of quitting much easier.

How to use the patch

The standard way of using NRT is as follows:

• The sustained release patch provides a maintenance dose of nicotine throughout the day and night. Instruct patients to put on the patch the night before their quit date to ensure a therapeutic nicotine level upon waking in the morning. In case of interrupted sleep, they may switch to mornings.
• The patient should stick the patch on the upper torso on easily reachable, bare skin. Patches should be replaced every 24 hours and put on different skin areas to avoid irritation.
• Recommend that patients use nicotine chewing gum or a nicotine inhaler as needed, or on a breakthrough basis, in much the same way that immediate-release morphine is provided to patients taking MS Contin for pain. This allows patients to titrate their level of nicotine. There is evidence that concurrent use of the patch and an immediate-release NRT (e.g., inhaler, gum or lozenge) is more effective than the patch alone (Bohadana et al., 2000).

The patient can also use NRT before beginning the quit attempt:

• Nicotine gum or an inhaler can be used as a substitute for cigarettes as a way of preparing to quit. Because it takes time to learn how to use both delivery systems, patients often benefit from some experimentation before actually trying to quit.
• Using immediate-release NRT before the quit date allows patients to begin to disconnect the emotional and habitual cues associated with smoking from the experience of having a cigarette.
• Applying a patch before the quit attempt encourages patients to significantly reduce their smoking and can increase their confidence in their ability to quit. Most patients are somewhat uncomfortable about smoking while on the patch, which serves as a check on their smoking.

Determining the patch dose

Several tools have been designed to objectively assess the appropriate patch dose. The most well-known tool is the Fagerström Test for Nicotine Dependence.

For most people who smoke one pack per day or less, the following is a reasonable starting point:

• more than 15 cigarettes per day: 21 mg patch (Step 1)
• seven to 15 cigarettes per day: 14 mg patch (Step 2)
• fewer than seven cigarettes per day: 7 mg patch (Step 3).

People who smoke one pack per day absorb 1.8 mg to 26.8 mg of nicotine (usually 16 mg to 20 mg), depending on how they smoke.

Monitoring the patch dose

If the patch dose is adequate, the patient should feel relatively comfortable between cravings. The patient may still have strong urges during the day, but most of the time will not feel physical cravings or discomfort. A persistent need for a cigarette or no improvement while on the patch strongly suggests that the dose is inadequate.

If the dose is inadequate, the patient will experience some of the ongoing physical discomfort of withdrawal, including irritability, dysphoria, restlessness, anxiety, insomnia, headache, decreased concentration and strong cravings.

If the dose is too high, the patient will experience symptoms of nicotine overdose, including nausea, cramps, dizziness, palpitations and dysphoria.

Increasing the nicotine dose

The use of larger doses of nicotine by patients who smoke heavily and who are highly tolerant to the effects of the drug makes theoretical sense.

For a patient who smokes heavily, a good starting point is to recommend one 21 mg patch per pack of cigarettes smoked per day.

If a patient experiences symptoms of withdrawal on a 21 mg patch, the dose should be increased. Recommend that the patient increase the dose in 7 mg increments, every three to seven days.

Patients who smoke two packs per day will experience a reduction in nicotine levels if they use 42 mg of nicotine (two 21 mg patches) daily.

The Nicotine Dependence Clinic at the Centre for Addiction and Mental Health routinely uses doses from 21 mg to 42 mg (in addition to immediate-release NRT as needed). Doses as high as 84 mg (four 21 mg patches) have been used successfully with patients who smoke very heavily.

Significantly higher smoking cessation rates have been observed with high-dose nicotine patches (more than 22 mg) compared with standard dose nicotine patches (less than 22 mg) (Canadian Agency for Drugs and Technologies in Health, 2014).

Duration of NRT

It is recommended that the patch and other forms of replacement should be used for as long as needed to maintain or prolong abstinence. The Lung Health study demonstrated that long-term NRT use is safe (Murray et al., 2009).

NRT product monographs recommend approximately two to three months of use, which is the length of time these products were used in early clinical trials. Many patients are not ready to stop using NRT after three months.

To prevent relapse, patients should be instructed to taper off NRT slowly. This helps them adjust to lowering nicotine levels (e.g., three to four weeks for every level).

Nicorette gum usage instructions also apply to generic nicotine gum.

All
medicines have risks and benefits. You need to weigh the risks of
taking Nicorette Gum against the benefits it will have for you.

If you have
any concerns about taking this medicine, ask your doctor or pharmacist.

Please
print this page and keep the printout with the medicine. You may
need to read it again.

What
is Nicorette Gum used for?

Nicorette Gum helps you to give up smoking by relieving the desire
to smoke, as well as some of the unpleasant effects, which smokers
experience when they stop smoking.

Nicorette Gum
is also used to help smokers who need to temporarily stop smoking
e.g. on long air flights. Nicorette Gum can also help reduce the
amount of cigarettes smoked in smokers who are unable or unwilling
to quit.

How
does Nicorette Gum work?

Smokers have both a physical reliance on nicotine (i. e. the body
becomes dependent on nicotine) and a psychological reliance on the
smoking habit.

When you give
up smoking, your body will miss the effects of nicotine and you
will miss the habit of smoking.

Nicorette Gum
helps you to tackle these two sides of the problem separately, instead
of all at once.

It is your body’s
dependence on nicotine, which causes withdrawal symptoms when you
suddenly stop smoking. Nicotine is an addictive substance. Symptoms
may include irritability, restlessness, depression, weight gain,
and craving for cigarettes.

Nicorette Gum
is intended to ease such withdrawal symptoms by providing your body
with nicotine. This leaves your mind free to concentrate on overcoming
your psychological desire to smoke.

Before
using Nicorette Gum
When you must not use the Nicorette Gum

Do not
use Nicorette Gum if:
– You
are pregnant or intend to become pregnant

There is medical evidence that nicotine in any form may be harmful
to an unborn child. Therefore it is recommended that you do not
use Nicorette if you are pregnant or intend to become pregnant,
unless you are unable to stop smoking without nicotine replacement.
Talk to your doctor before using Nicorette Gum during pregnancy.


– You are breast-feeding or intend to breast-feed

Nicotine passes freely into breast milk, and can affect the health
of the baby. Therefore it is recommended that you do not use Nicorette
Gum if you are breast-feeding or intend to breast-feed.

– You have had a recent heart attack or stroke

– You have heart disease such as palpitations (fast or irregular
heart beats) or uncontrolled angina (chest pain)

– You are a non-smoker

– You are under 18 years old

There is not enough information about the use of Nicorette Gum in
children.

– You are allergic to nicotine or are sensitive to any components
of the chewing gum.

You should
not use Nicorette Gum if the expiry date printed on the carton has
passed or the packaging is torn or shows signs of tampering.

Do not give
Nicorette Gum to anyone else to use as it is recommended that they
seek professional advice prior to starting treatment.

Before
you start to use Nicorette Gum

If you have had any of the following, you should ask for your doctor
or pharmacist’s advice before using Nicorette Gum.

These medical
conditions may need consideration by or discussion with your doctor
or pharmacist. You and your doctor or pharmacist can then weigh
up the risk of using Nicorette Gum against the benefits you will
get if you stop smoking.

The medical
conditions include:
Angina
(chest pain) or any other problem with your heart or blood vessels
such as pain in one or more legs when you walk

High blood pressure

Previous stroke

Kidney disease

Liver disease

Stomach ulcer or pain

Hyperthyroidism (a disorder of the thyroid gland)

Phaeochromocytoma (a tumour of the adrenal gland)

Diabetes.

If you have dentures, dental caps or partial bridges.

Nicorette Gum
may stick to your dentures, dental caps or partial bridges and therefore
may cause damage to your dental work. It is important that your
dental work is kept clean. You should stop chewing Nicorette Gum
if it is sticking to your dental work and discuss further use of
Nicorette Gum with your doctor and dentist.

Taking
other medicines

If you are taking any other medicines, including medicines that
you buy without a prescription, in a pharmacy, supermarket or health
food shop, the way these medicines work may be affected once you
stop smoking.

These medicines
may include:
Theophylline
(asthma medication)

Insulin

Imipramine (antidepressant)

Pentazocine (pain medication).

You may wish to seek professional advice from your doctor or a pharmacist
before you start to use Nicorette Gum.

Using
Nicorette Gum
What is the proper chewing method?

Do not chew Nicorette Gum when eating or drinking.

This causes
excessive swallowing of nicotine, reducing the effectiveness of
Nicorette. Do not drink acidic beverages, such as coffee or soft
drinks, for 15 minutes before chewing as they can interfere with
the absorption of nicotine.

To get the
full effect from Nicorette Gum these steps should be followed carefully:
Place
one piece of Nicorette in your mouth and chew it slowly until you
feel a slight tingling sensation.

When you feel the tingling (usually after about 10 chews), place
the piece of gum under your tongue or between your cheek and gums
until the tingling has gone. This will take about one minute.

When the tingling has gone, continue to chew the gum slowly until
the tingling returns. Then again place the gum under your tongue
or between your cheek and gums.

Chew each piece of Nicorette in this way until you no longer experience
the tingling sensation. Each piece of Nicorette will usually last
about 30 minutes.

Dispose of the chewed pieces of gum neatly, e.g. return to the bubble
pack.

Why
is proper chewing so important?

Nicorette Gum releases nicotine into your saliva. This nicotine
is absorbed through the lining of your mouth and enters your bloodstream.
Any nicotine that is swallowed in saliva is broken down in your
stomach. It is therefore wasted.

It is important
to chew Nicorette Gum slowly so that the nicotine is released a
little at a time and absorbed through the lining of the mouth.

If Nicorette
Gum is chewed too quickly or for too long, a lot of saliva is produced
and swallowed which reduces Nicorette’s ability to work effectively.
Too much chewing may also produce an unpleasant strong taste, which
is a useful sign that you should slow down or stop chewing. Chewing
too quickly may at first irritate the throat or cause hiccups or
make you feel sick.

So remember
that if the taste is too strong you are chewing too fast!

Which
strength of Nicorette Gum should I use?

Nicorette Gum is available in 2 milligram (mg) and 4 mg strengths.
Usually, the 4 mg strength is recommended if you smoke 20 cigarettes
or more in a day or are a smoker who has not been able to quit smoking
using the 2 mg strength. Otherwise you should use the 2 mg strength.

How
much Nicorette Gum should I use?

The amount of Nicorette Gum you chew each day depends on your former
smoking habits. Usually, it is recommended that a piece of Nicorette
should be used when the urge to smoke is felt. About 8 to 12 chewing
gums, of either the 2 mg or 4 mg strength, each day will be adequate.
No more than 24 gums should be used daily.

How
long should I continue to use Nicorette Gum?

To quit
smoking:

It is important that you use Nicorette Gum for long enough to help
overcome your dependence on cigarettes. Normally this period will
be at least 3 months. Then you can start to slowly wean yourself
from using the gum. When you are only using 1 to 2 chewing gums
each day, then you can stop the treatment.

Temporary
abstinence:

Nicorette chewing gum should be used during smoke-free periods,
for example in smoke free areas or in situations when you wish to
avoid smoking.

Smoking
reduction:

Use Nicorette Gum between smoking episodes to prolong smoke-free
intervals and with the intention to reduce your smoking as much
as possible. If after 6 weeks you have not reduced the number of
cigarettes smoked each day, then you should seek professional advice.

You should try
to quit smoking as soon as you feel ready, but no later than 6 months
after starting your treatment. If 9 months has passed since starting
Nicorette Gum and you have still not been able to make a serious
attempt at quitting smoking, then seek professional advice.

Regular
use of the gum after 12 months is not recommended. Some ex-smokers
may need longer treatment to avoid returning to smoking.

Should
I combine use of Nicorette Patch(s) and Gum?

Normally Nicorette Patch or Gum alone would provide enough nicotine
to help most people control their craving for cigarettes. However,
some people may find that even though they are using nicotine replacement
therapy (NRT) they still have intense or frequent cravings they
find difficult to cope with. If you are one of these people you
may benefit from combining Nicorette Patch use with Nicorette 2
mg Gum.

Each morning
apply a Nicorette 15 mg/16 hour Patch to an intact area of skin.
The Nicorette Patch should be removed before going to bed. After
applying the Nicorette Patch use Nicorette 2 mg Gum whenever a craving
occurs.

For best results
try to chew at least 4 pieces of Nicorette Gum every day. Most people
will use 5-6 pieces. Do not use more than 24 pieces of gum.

The combination
of Nicorette Patch and Nicorette Gum should be used in this way
for 6-12 weeks. After this time if required you can wean yourself
off NRT by either:

Use the Nicorette
10 mg/16 hour Patch for 3-6 weeks and then use the Nicorette 5 mg/16
hour Patch for 3-6 weeks while using the same number of pieces of
Nicorette Gum in a day that you have routinely used. Then when a
patch is no longer needed, gradually reduce the number of pieces
of gum until you no longer need them. OR

Stop use of the Nicorette 15 mg/16 hour Patch and then gradually
reduce the number of pieces of Nicorette 2 mg Gum that are used
until you no longer need them.

If you use too much (overdose) or in accidental poisoning

Overdose of nicotine can occur if nicotine is used excessively,
either from chewing too many pieces of Nicorette Gum at the same
time or rapidly one after the other, and/or smoking.

Symptoms
of overdose or poisoning include:

Nausea and vomiting

Salivating

Diarrhoea

Abdominal pain

Cold sweats

Weakness

Disturbed hearing

Headache

Breathing difficulties

Weak, rapid or irregular pulse

Loss of consciousness.

Children
have a greater risk of poisoning from nicotine, therefore it is
important to keep Nicorette Gum out of reach of children.

In the event
of yourself or someone else showing symptoms seek medical advice.
Immediately telephone your doctor or the National Poisons Information
Centre for advice, or go to Accident and Emergency at your nearest
hospital.

What
are the side effects?

Nicotine like all other medicines may cause unwanted side effects
in some people.

Seek professional
advice from your doctor or pharmacist as soon as possible if you
do not feel well while you are using Nicorette Gum. Most of the
undesirable effects reported by users of Nicorette occur during
the first weeks after beginning treatment and are most likely due
to chewing incorrectly or to the effects of nicotine. Some are minor
and temporary but others may need medical attention.

You may
notice the following:
Headache


Nausea and/or vomiting

Hiccups

Sore mouth or throat

Jaw-muscle ache

Redness of the skin

Hives

Mouth ulcers.

Some effects, such as dizziness, headache and sleeplessness may
be withdrawal symptoms due to low nicotine levels.

If any of
these effects do not go away, or you have any other undesirable
effects during use, tell your doctor or pharmacist.

After
using Nicorette Gum

Storage

The expiry date of the Nicorette Gum is on the label of the carton
and on the foil of the blister pack. Do not use Nicorette Gum if
the expiry date has passed.

Leave all
pieces in the blister pack until immediately before use.

Store Nicorette
Gum below 25°C. Storage in a car in hot weather may cause deterioration
of the Gum.

KEEP
NICORETTE GUM OUT OF REACH OF CHILDREN.
(See section on ‘Symptoms of overdose or poisoning’).

Disposal

When Nicorette Gum is no longer needed, dispose of carefully, where
children or animals cannot get it.

Product
description
What does Nicorette Gum look like?

As well as the Nicorette Gum there is an additional mint flavour:
Nicorette Mint Gum.

The 2 mg strength
is a beige colour. The 4 mg strength is a yellow colour.

Nicorette Gum
and Nicorette Mint Gum are available in packs of 30 and 105 pieces.

Nicorette
Gum is a General Sales Medicine.

Ingredients

The active ingredient in Nicorette Gum is nicotine-resin complex.

Nicorette
Gum:

Other ingredients in both strengths of Nicorette Gum are chewing
gum base, sorbitol powder, sorbitol 70%, flavour for smoker, haverstroo
flavour, sodium carbonate anhydrous, and glycerol 85%.

Nicorette
Mint Gum:

Other ingredients in both strengths of Nicorette Mint Gum are chewing
gum base, xylitol, peppermint oil, menthol, sodium carbonate anhydrous,
and magnesium oxide light.

An ingredient
found only in the 2 mg Nicorette Gum and Nicorette Mint Gum is sodium
hydrogen carbonate.

An ingredient
found only in the 4 mg Nicorette Gum and Nicorette Mint Gum is quinoline
yellow Al-lake E 104.

Supplier

Nicorette Gum is supplied in New Zealand by:

Pharmacia

PO Box 11-282

Ellerslie

Auckland

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GoodSense® Nicotine Polacrilex Gum 2 mg (nicotine) Original Flavor

Curb Your Nicotine Cravings

Compare to the active ingredient in Nicorette® Gum. GoodSense® Nicotine Polacrilex Gum, 2 mg (nicotine), Original Flavor is part of a Nicotine Replacement Therapy. Nicotine Replacement Therapy (NRT) is designed to wean your body off cigarettes. 

Nicotine Replacement Therapy helps regulate, control, and gradually reduce your body’s cravings for nicotine. Smoking has two addictive components, a physical and a mental need for the nicotine in tobacco. You need to conquer both to succeed. Nicotine Polacrilex Gum can ease your physical nicotine addiction, but your readiness and resolve are necessary to help overcome the mental side of your cigarette dependence. So once you’re ready, it’s time to begin. For more information and for a FREE individualized stop-smoking program, please visit www.SmokeFreeHabits.com.

What’s Inside

Active ingredient: Nicotine polacrilex (equal to 2 mg nicotine), stop-smoking aid. 

Inactive ingredients: acesulfame potassium, calcium carbonate, carnauba wax, flavors, gum base, sodium bicarbonate, sodium carbonate anhydrous, sorbitol, talc.

Directions

• If you are under 18 years of age, ask a doctor before use.
• Before using this product, read the enclosed User’s Guide for complete directions and other important information.
• Begin using the gum on your quit day.
• If you smoke your first cigarette within 30 minutes of waking up, use Nicotine Polacrilex Gum, 4 mg.
• If you smoke your first cigarette more than 30 minutes after waking up, use Nicotine Polacrilex Gum, 2 mg according to the following 12 week schedule: Weeks 1 to 6, 1 piece every 1 to 2 hours; weeks 7 to 9, 1 piece every 2 to 4 hours; weeks 10 to 12, 1 piece every 4 to 8 hours.
• Nicotine gum is a medicine and must be used a certain way to get the best results.
• Chew the gum slowly until it tingles. Then park it between your cheek and gum. When the tingle is gone, begin chewing again, until the tingle returns.
• Repeat this process until most of the tingle is gone (about 30 minutes).
• Do not eat or drink for 15 minutes before chewing the nicotine gum, or while chewing a piece.
• To improve your chances of quitting, use at least 9 pieces per day for the first 6 weeks.
• If you experience strong or frequent cravings, you may use a second piece within the hour. However, do not continuously use one piece after another since this may cause you hiccups, heartburn, nausea or other side effects.
• Do not use more than 24 pieces a day.
• It is important to complete treatment. If you feel you need to use the gum for a longer period to keep from smoking, talk to your health care provider.

90,000 What is the best way to use nicotine replacement therapy to quit smoking?

Relevance

Nicotine replacement therapy (NRT) are medications available as patches, chewing gums, nasal or oral sprays, inhalers, and lozenges / lozenges that deliver nicotine to the brain. The purpose of NRT is to replace nicotine, which smokers usually obtain from cigarettes, so that their need to smoke is reduced and they can quit smoking altogether.We know that NRT improves the chances of successful smoking cessation and that people use this treatment to help them quit smoking. This review looks at the various ways NRT is used to quit smoking, and which type of NRT is best to quit smoking for six months or longer.

Research characteristics

This review includes 63 clinical trials with 41,509 participants. All studies were conducted with people who wanted to quit smoking, and most of the studies involved adults.The people included in the studies usually smoked at least 15 cigarettes per day at the time of the study start. The research lasted for at least six months. The evidence is current as of April 2018.

Highlights

The use of nicotine patches with other types of NRT (such as chewing gum or lozenges / lozenges) increases the likelihood of successful smoking cessation in a range of 15% to 36% than with only one type of NRT.The likelihood of successful attempts to quit smoking was higher if participants used high-dose nicotine patches (containing 25 mg nicotine (used within 16 hours) or 21 mg nicotine (used within 24 hours) versus 15 mg nicotine (used within 24 hours). 16 hours) or 14 mg nicotine (used within 24 hours)) or high nicotine gum (containing 4 mg nicotine versus 2 mg nicotine). Using NRT before and after a day of smoking cessation may help more people quit smoking than using it only after a day of smoking cessation, but more evidence is needed to strengthen this finding.However, people who smoke have an equal chance of successfully quitting smoking, whether they use a nicotine patch or another type of NRT such as chewing gum, lozenges, or nasal spray.

We also looked at how long NRT is needed, whether NRT should be used on a schedule or on demand, and whether more people quit smoking if NRT was provided free of charge or for a fee. However, more research is needed to answer these questions.

Most studies did not address safety issues. In those studies that looked at safety issues, very few people reported adverse effects of NRT. Evidence from another review indicates that NRT is a safe treatment.

Quality of evidence

There is high certainty evidence that combined NRT works better than NRT alone, and that chewing gums with higher doses of nicotine work better than those with lower doses, and that there is no difference in effect between different types of NRT (such as like chewing gum or lozenges / lozenges).This means that further research is very unlikely to change our conclusions. This is because the evidence is based on a large number of participants and the research has been well conducted. However, the quality of the evidence was moderate, low, or very low for all the other questions we looked at. This means that our conclusions may change if new research is carried out. In most cases, this is due to the insufficient number of studies, the design and the low power of the studies conducted.We rated the quality of the evidence regarding the safety of various NRT treatments as low or very low, as many studies did not report safety.

Chewing mixtures. A dangerous hobby. / News / Administration of the city district of Istra

Chewing mixtures. A dangerous hobby.

The State Duma adopted amendments to the law “On protecting the health of citizens from exposure to second hand tobacco smoke and the consequences of tobacco consumption” providing for the introduction in the country of a ban on the sale of snus (sucking tobacco).In addition, the Code of Administrative Offenses provides for Article 14.53 of the Administrative Code (non-observance of restrictions and violation of prohibitions in the field of trade in tobacco products and tobacco products). They provide for the expansion of the list of prohibited smokeless tobacco products and the establishment of additional restrictions on trade in them.

Changes in legislation have spurred the production of alternative products – gummies and tobacco-free snus. In fact, if you look at the definition of snus, you will notice that it assumes the presence of tobacco.Therefore, the name itself – “tobacco-free snus” – is nothing more than a marketing ploy that attracts the attention of consumers. In fact, such a combination is meant to include non-tobacco gummies. Despite the fact that gummies do not contain tobacco, they contain nicotine, a substance that causes addiction. Its content is 5 – 30 times more than in a regular cigarette. These mixtures are sold in the form of lollipops, caramel, chewing gum, herbal mixtures. Nicotine in the form of a concentrate is applied to the cellulose base of the gum mixture.Additional components are flavors and edible salt.

As a result of resorption of chewing mixtures sold under the guise of sweets containing nicotine, schoolchildren lose consciousness, breathing stops, coma sets in, and the child may die. Snus and their analogues are very addictive and addictive.

Although the gummies do not contain tobacco, they harm the body in the same way as regular snus because they contain nicotine and flavorings.

Symptoms and external signs appearing in children using snus and their analogues:

• deterioration of respiratory function,

• irritation of the mucous membrane of the eyes,

• headaches,

• heart palpitations,

• nasal congestion,

• sore throat, cough,

• irritability,

• loss of appetite, dizziness and nausea,

• impairment of thought processes, memory,

• decreased attention.

In addition, these mixtures are highly carcinogenic. Snus contains 28 known carcinogens, including nickel, polonium-210 (a radioactive element) and nitroamines. Their concentration is 100 times higher than the MPC.

The harm of snus without tobacco includes:

• Causes serious oral health problems.

• The risk of developing cancer of the pharynx and oral cavity is 4 to 6 times higher than that of those who do not use it.

• Affects the development of strokes, heart attacks, increased blood pressure, redness and swelling of the nasal mucosa, watery eyes, turning into chronic forms.

• Aromatic additives in tobacco may cause allergic reactions.

• Nicotine contained in tobacco adversely affects the reproductive function of both men and women.

• Chewable mixtures, like regular cigarettes, contain nicotine, therefore, can cause nicotine addiction. Moreover, in this case, nicotine is absorbed more slowly, so the effect on the body is longer.

• Snus can be even more harmful than cigarettes.because the dose of tobacco is difficult to accurately measure and there is a risk of overdose with subsequent unpredictable consequences.

Rospotrebnadzor laboratory confirmed the potential danger of the use of such products, which poses a threat to the life and health of the population, especially children and young people.

The Department of Rospotrebnadzor in the Moscow Region, in accordance with the order of Rospotrebnadzor, conducts inspections of trading enterprises selling nicotine-containing chewing mixtures in order to take the most stringent measures provided for by the legislation of the Russian Federation, and, in cases established by the Law, immediately transfer materials to the relevant law enforcement bodies for resolving the issue of initiating criminal cases.

Mezen Central District Hospital

Getting rid of any addiction is a serious test of strength. For example, many people are trying to quit smoking. And only some of them reach the goal. What effective methods should you use to bring yourself closer to your cherished goal and get rid of nicotine addiction?

According to statistics, about 70% of smokers dream of getting rid of their bad habit.Less than 20% of them have never tried to quit smoking before, but 80% regularly try to combat addiction. How to quit smoking on your own is a must for every smoker who wants to take the path of a healthy lifestyle.

What are the reasons for smoking

Each person has their own reasons for smoking. But most start smoking at a young age only to join the group of smoking peers.One gets the impression that friendship, understanding and fun will come with a lit cigarette. Since the body gets used to the action of nicotine over time, there is a desire to regularly fill up the missing sensations, so the smoker increases the number of cigarettes smoked per day. But even this no longer brings such pleasure, because against the background of temporary euphoria, the first health problems arise (cough, shortness of breath, dizziness, weakness), which do not go unnoticed.

A man smokes a cigarette at a bus stop while waiting for a bus, waiting for a call, between work done, talking with a friend – just to keep himself busy.Some do not attempt to quit smoking for fear of being alone. When all friends and acquaintances smoke, you do not want to “get out” of the company and become a “black sheep”, otherwise they will not understand. It is better to stay out of the way than to get lung cancer as a result of the habit of supporting the company. But here everyone must decide for himself what is more important to him: instant pleasure or life without the risk of developing many diseases.

How to set yourself up to quit smoking

You need to understand that with cigarettes you gain nothing, but only lose your health, beauty, youth.By abandoning them, you will not lose anything at all. Don’t you want to see your children grow up, take your grandchildren in your arms and dance at their wedding? With every cigarette you smoke, your chances of living up to this become less and less.

How to start quitting smoking

1. Decide to do it now. There are no more excuses: not tomorrow, not from Monday, not from the new year, but right now.
2. Tell your family and friends about your intention.Ask them for support and help. It will be great if someone else decides to quit smoking with you, so you support each other.
3. Get rid of all the attributes of smoking around you: ashtrays, lighters, a jacket in which you went out for a smoke break or a pillow on which you sat on the balcony, inhaling with tobacco smoke. All these things don’t belong in your life anymore, put them in the trash can.
4. Calculate how much money you spend on cigarettes per month. Put this amount in an envelope and hide it away.At the end of the first month without smoking, get this stash and buy yourself a gift, reward yourself for the path you have traveled. And do this every month of your life without addiction.

Basic ways to combat smoking

An easy and affordable way to quit smoking is to stop smoking and that’s it. But some people find it difficult to cope with addiction on their own, so they find additional ways to help cope with the consequences of quitting tobacco. Use nicotine patches to reduce the effects of withdrawal symptoms when quitting tobacco.When they are used, nicotine enters the body, but the lungs are not negatively affected by smoke. True, the cardiovascular system still suffers from the effects of nicotine. Therefore, gluing the plaster is only a temporary stage until the desire to smoke disappears. Nicotine gum works the same way. It must be chewed slowly in the mouth, holding the saliva, and then swallowed. There are also special inhalers with nicotine content. If you want to take a drag on a cigarette, you need to take about 80 breaths through the inhaler.This way the body will receive the required dose of pure nicotine.

Main stage

The task of this stage is to overcome the urge to smoke. It usually lasts no more than 5-10 minutes. For this it is proposed:

• Use alternative behavior tactics if the urge to smoke is triggered by something previously associated with cigarettes.
• Get distracted, do what you love, read a book, play a computer game, etc.
• Keep your hands busy, such as puzzles or knitting.
• Do some exercise. Breathe deeply: relax, slowly, straighten your shoulders, gain a full chest of air, hold your breath for a minute, exhale slowly. Repeat 5 times.
• Chew gum, suck on candy, or drink water (green tea is especially helpful).
• Eat an apple or some other fruit.
• Taking a shower or bath will help you relax.
• Brush your teeth.
• Rinse mouth with baking soda solution.

Avoid places where people smoke and vice versa, go to places where smoking is prohibited. For the first two months, it is useful to take hot baths and go to the bathhouse. Drink plenty of fluids, preferably juices and mineral water. For the first two weeks, give up alcohol, coffee, spicy and salty foods, all of which provoke the desire to smoke. Eat more vegetables and fruits. Exercise, but remember that excessive exercise is dangerous for smokers. Experts recommend refraining from dieting while quitting smoking, as it is very difficult to survive two of these tests at the same time.

Additional ways to quit smoking that, according to scientific experiments, actually work.

Substitution therapy

The most common of these is the replacement of smoking with the use of nicotine-containing drugs. These are nicotine patches, chewing gums, inhalers. At the same time, the effect of nicotine remains, but the toxins contained in tobacco smoke no longer enter the body. These remedies can be used long enough until the craving for cigarettes disappears.A nicotine patch is applied to the shoulder or thigh once a day and allows a certain dose of nicotine to enter the body through the skin. Every three weeks the patch is changed to a weaker one. Nicotine chewing gum allows nicotine to travel through the oral mucosa. Its disadvantage is the unpleasant taste for some and the need to chew it for a long time, about 30 minutes. The nicotine inhaler is shaped like a cigarette and allows you to inhale nicotine. Since its use mimics cigarette smoking, it may appear more effective to hard-core smokers.It makes sense to use pills from smoking only for “heavy” smokers.

Keeping a diary

Another good visual accompaniment to smoking cessation is a diary. As with any restrictive action on the body, quitting nicotine (as well as sugar or caffeine) is a serious stress. To reduce discomfort and prevent breakdowns, it is helpful in the first step to record how many times a day you smoke and how many cigarettes you smoke in general.

Social networks

It’s great if you have a friend who has quit smoking.Then you can ask questions that arise along the way or ask for support (and you will need it) at any time. On the other hand, joining your virtual friends to the operation is no less successful. In the meantime, they will gladly give advice and discuss options for deviating from the original plan with you. In addition, psychologists confirm that high-profile statements on social networks such as “I will quit smoking from today” or “I will not eat sugar from tomorrow” certainly increase social pressure.

Training

Attacks of an acute desire to smoke in case of quitting smoking, as a rule, are limited in time. They usually last from 5 to 10 minutes, and experts point out that the most important thing here is to keep yourself busy. Craving found at work? It’s OK. Go for a walk, or if there is no time and the weather is short, walk around the office to see how your colleagues are doing. Keep in mind that some research has shown that lifting weights can help you quit smoking faster than cardio.So, it is quite possible that you should temporarily change the type of training and work with weight.

Alternative methods

Alternative treatments for nicotine addiction include acupuncture (reflexology) and hypnosis. In acupuncture, needles are inserted into the auricle, affecting certain structures of the brain. As a result, the “smoker’s reflex” is destroyed. The method of hypnosis is that, having brought the patient to a state of relaxation, the doctor instills that he is disgusted with smoking.We hope that the above information will be helpful in helping you to quit smoking.

The memo was prepared by LS Goncharova, an employee of the Department of Civil Defense and V of the FBUZ “Center for Hygiene and Epidemiology in the Kaliningrad Region” using materials from the Russian Academy of Medical Sciences (RAMS) and materials published in the professional medical publication “Medical newspaper” No. 56 -2017

Nicorette chewing gum: instructions for use

In the modern world, people are trying to quit smoking, but most attempts remain unsuccessful.A bad habit causes a person to be highly addicted to nicotine, and also leads to nervous disorders. To quit a bad habit, you need to go through a long course of therapy, as well as have willpower.

Currently, there is a special development from pharmaceutical companies in a special form of chewing gum containing medical nicotine. Nicorette chewing gum helps patients in their quest to quit smoking by reducing nicotine addiction. Below will be presented instructions for use, the basic principle of exposure to the body, as well as possible adverse effects on the body during treatment.

Form of release and varieties of chewing gum

Nicorette is produced chewing gum in two main forms, which differ in the color of the outer shell. The appearance of the drug is similar to a white (in the case of a dosage of 2 mg) or yellowish lozenge (in the case of a dosage of 4 mg).

The concentration of the active drug depends on the form of release of gum. Gum is sold in packs of 15 pieces, which are located in special blisters.

Chewing gum is available in two versions.The most classic option is mint gum, but you can get a fruity flavor if you like.

Instructions for use

Nicorette chewing gum is used as a regular chewing gum, it must be actively chewed before the onset of the effect. The instructions for use are quite simple, they are as follows:

1. Take the blister out of the package and take out one lozenge.
2. Place the gum in your mouth and start chewing.
3. After chewing, place the gum in a bag and discard.Chewing gum cannot be reused.
4. This procedure allows you to replace smoking with a less bad habit, and then helps to completely quit smoking.

If you want to quit smoking, you need to go through an interview with a doctor who will help you choose an individual treatment plan and write out a list of medications for therapy.

Chewing gum composition

The main therapeutic effect of Nicorette gum is achieved due to the presence of medicinal components in its composition.The composition of the chewing gum is represented by the following substances:

• Medical nicotine acts as the main active ingredient, in a dosage of 2 mg, chewing nicotine is 11 mg in percentage, in a dosage of 4 mg, the amount of nicotine is 22 mg in equivalent.
• Additional elements in the chewing gum allow to add consistency, shape and flavor to the preparation. Various polymers and compounds are used as fillers.
• For the casing, additionally gum arabic, titanium dioxide and carnauba wax are used.

Pharmacological action

Nicorette chewing gum contains medical nicotine, which, when chewed, enters the systemic circulation through the mucous membrane of the cheeks and gums. After 5-7 minutes, nicotine can be detected in the blood, and after half an hour, its maximum concentration is reached. Medical nicotine has the same effects as regular smoking, but it is safer and more harmless to health.

The drug is transformed in the liver, lungs and kidneys, excreted in the urine.In case of cardiac disorders or in case of damage to the excretory organs, liver and lungs, it is not recommended to take the drug.

Indications for use

Since Nicorette nicotine chewing gum contains medicinal nicotine, its main purpose is as follows:

• Chewing gum is indicated for people who want to quit smoking as a maintenance therapy.
• To reduce complications from abrupt cessation of cigarettes.
• Personal desire of the patient to reduce the number of cigarettes that he smokes per day.

Dosage

Currently, there are two forms of the drug in the form of Nicorette gum, which differ in dosage:

• The 2 mg dosage contains 11 mg of medical nicotine, is produced in the form of a white square with sides 15 × 15 × 6 mm. The presented form is intended for patients who smoke less than one pack of cigarettes per day.
• A dosage of 4 mg contains 22 mg of medical nicotine, also available in the form of a square with sides 15 × 15 × 6 mm.The color of the gum is different, it can be light yellow or brown with a greenish tint. This dosage is indicated for patients who smoke more than one pack of cigarettes per day.

Side effects

If you take Nicorette gum according to the instructions, the risk of side effects is very small, but the following consequences from taking the drug are possible:

• Side effect can manifest itself in increased salivation and hiccups in the first 2-3 weeks of use …
• Adverse effect is expressed on the central nervous system, pain in the head, dizziness, feelings of malaise may occur.
• From the side of the CVS, a change in heart rate and a change in rhythm are manifested.
• The organs of the gastrointestinal tract may be affected by the drug, in rare cases, dyspeptic disorders occur.
• An allergic reaction occurs on the skin, itching and redness of the skin is possible.
• For certain groups of people, there is a contraindication to the use of chewing gum.These include children and people under the age of 18, as well as people with intolerance to nicotine and drugs with its content.

It is necessary to use the medicine only after an examination and a conversation with a doctor, who will select an individual treatment regimen.

Directions for use

One of the most important issues is how the chewing gum is used. The package contains instructions on how to chew Nicorette. The patient needs to use the medicine as follows:

1. If you want to smoke a cigarette, take one lozenge from the blister and place it in the mouth, and then chew it.
2. When a characteristic taste is experienced, attach the gum to the gum to absorb nicotine.
3. When the taste has disappeared, you can continue to chew the gum to prolong the effect of the drug.
4. If the patient shows signs of an overdose, it is necessary to stop taking the drug.
5. You can chew 8-12 gums per day, with the maximum dose not exceeding 15 chewing gum per day.

If you smoke more than one pack of cigarettes a day, you should use a dosage of 4 mg, if you smoke less than one pack, a lighter gum in a dosage of 2 mg is suitable.Before using the medicinal product, you should consult your doctor.

Storage conditions

Nicorette gum should be placed in a dark place with an air temperature not exceeding 25 ° C. The shelf life of the chewing gum in the package is up to 3 years, you can not use the expired product.

When using expired chewing gum, there may be cases of unwanted effects. You can find information about the date of manufacture and expiration date on the outer surface of the package.

Interaction with other drugs

The use of Nicorette chewing gum in the prescribed amount does not cause adverse effects on the body, and there were no reliable clinical contraindications to the combination and combined administration of drugs.

However, due to the peculiarities of the effect of nicotine gum, as a result of treatment, hemodynamic disturbances caused by an increase in the action of adenosine may appear.

Nicorette chewing gum should not be used simultaneously with the administration of adenosine due to possible hemodynamic disturbances and an increase in angina pectoris pain.

WHAT IS SNUCE AND WHAT IS IT DANGEROUS? DRUG OR NOT? HOW IS IT ACCEPTED AND HOW DOES IT WORK?

Snus is a smokeless tobacco product that comes in various forms and
used as chewing tobacco . Its in the form of portioned sachets
or loose tobacco is placed between the gum and the upper (sometimes lower) lip on
5 – 30 minutes for nicotine to be absorbed into the bloodstream and enter the body,
bypassing the larynx and lungs. This substance is not only tobacco.It includes
includes tobacco, water as a humectant, baking soda to enhance the flavor, and salt or sugar
as a preservative. Some mixes add essential oils for added aroma.
oils, leaves of other herbs, pieces of berries and fruits.

A LITTLE HISTORY AND ABOUT THE DISTRIBUTION OF SNUOS

Snus first appeared in Sweden in 1637 and is still in
to a greater extent, it was produced and used in this country. As of 2007
in Sweden 90,033 snus 90,034 was consumed by 24% of men and 3% of women, and in
In 1999, these figures were only 19 and 1%.This means that this view
chewing tobacco has become even more popular.

The use of snus has spread to other countries as well. He
became extremely popular in Norway and gained some popularity in
EU countries, USA and Russia. In all countries except the USA, Sweden and Norway, it
the sale was banned due to its harmful effects on the body. Harm
snus is rated as stronger than tobacco smoking .

In European countries, except Sweden, thanks to the efforts of WHO snus got
under the prohibition of legislation since 1993.In the Russian Federation, a ban on this form of sucking
tobacco was introduced in 2015. However, it is still being imported into
country under the guise of chewing tobacco and is freely sold on the Internet and other
retail outlets in different cities of the country.

TYPES OF SNUS

The industry produces two types of snus:

• portions
  – packed in small tea bags of 0, 3 – 2 g;
• loose
  – it is sold by weight in cardboard boxes with a plastic lid.

Portion Snus appeared in 1979 and has become more
popular. It is packed in different packages;

• mini
  0.3-0.4 g;
• standard
  (or large) – 0.8 – 1 g;
• maxi –
  1, 5 – 2 g.

Women usually prefer to take mini packs, while men prefer standard ones.

Bags can be brown – they are painted at the last stage
produced by tobacco and sprayed with water, or whites.Men usually
prefer brown packaging, while women prefer white.

Loose snus bought by weight and usually consumed by
1 – 2 g, laying behind the upper lip. Before insertion with fingers or
a lump is formed from a special dispenser.

Most of the snus is unflavored and has
taste and smell of tobacco. However, there are also flavored varieties with such additives.
like mint, lavender, lime, coffee, vanilla, melon, menthol, raspberry, bergamot, melon,
whiskey, etc.More often flavored snus sold in portions
form.

HOW DOES SNUS WORK?

Snus consumption , like cigarette smoking, is aimed at entering
the body is nicotine. Chewing tobacco contains much more nicotine than
in the smoking room. However, approximately the same amount enters the bloodstream.
30 minutes after filling a portion of snus, about 15 ng / ml is determined in the blood.
nicotine, and then during the dividing time the indicator is kept at 30
ng / ml.At the same time, unlike smoking, when using snus, it does not enter the body
tobacco smoke and substances in it. That is why at first use
snus may seem safe and less harmful. This is exactly the way it is
positioned by manufacturers.

SNUCE DEPENDENCE

Snus , like tobacco for smoking, inevitably causes nicotine addiction.
Many experts believe that physical and mental dependence on snus is much
stronger and getting rid of it is extremely difficult.That is why, in terms of the complexity of treatment
she is often put on a par with, if not narcotic, then with alcohol or
tobacco addiction.

Manufacturers are spreading this myth about snus – this product can reduce
cravings for smoking and even helps to cope with tobacco addiction. The truth
is only the first part of the myth – snus can really shorten
the number of smoked cigarettes to a minimum or even you can even quit 90,033 altogether
smoking cigarettes . However, the second part of the myth is a complete lie, since desire
smoking will be replaced by a craving for putting tobacco by the lip and nicotine addiction
won’t go anywhere.

Snus habituation occurs much faster, practical
lightning fast, and nicotine addiction is more pronounced. Even with
trying to keep 90,033 snus in the mouth for only 5 – 10 minutes into the blood
receive a large dose of nicotine. Attempting to substitute sucking tobacco for smoking
can be compared to trying to quit taking a light drug by
“Jumping” to a heavier one. In addition, the observations of specialists
show that many snus fans subsequently switch back to smoking
cigarettes.

Potential for development of dependence depends on the rate of admission
psychoactive substance into the brain. When you suck on tobacco, nicotine gets into
the brain, bypassing the bronchi and lungs, is much faster. In addition, in the most
a common serving of snus contains 5 times more
nicotine than in a cigarette. This is why sucking tobacco addiction
develops faster and manifests itself more strongly. It is not uncommon to cope with such
addiction without the help of a specialist is simply impossible.

Snus consists of tobacco, salt (or sugar), soda and water. All these
the substances are not narcotic and therefore sucking tobacco cannot be considered
drug. This analogy is usually drawn in connection with the appearance of
severe nicotine addiction to snus. Sometimes parents are alarmed by the form
sucking tobacco in sachets and they think the teenager has started
take drugs.

Snus is not a drug, but it has a very harmful effect
on the body and the nicotine addiction arising on the background of its intake needs
in treatment.The fight against his reception should begin as early as possible, since
addiction develops very quickly and is more difficult to treat. Harm
snus is obvious and cannot be considered a safe alternative to smoking.

CONSEQUENCES FROM SNUES

• Sucking
  snus in almost 100% of cases leads to the appearance of non-neoplastic lesions
  oral mucosa. It is constantly irritated and the cells stop
  function and develop normally.Snus is especially dangerous for persons before
  18 years. It causes her rapid keratinization even after a month of taking
  sucking tobacco. This condition is precancerous. Research
  conducted by the American Cancer Society show that up to
  28 carcinogens. These are nickel, nitrosamines, radioactive polonium-210. They are
  are extremely dangerous and increase the likelihood of developing cancer of the cheeks, gums and
  the inner surface of the lips 40 times.
• By
  research data due to snus intake the risk of developing pancreatic cancer in
  The USA increased by 40%, and in Norway – up to 67%.According to other studies,
  published in the medical journal “The Lancet”, this indicator
  increases the risk of a cancerous tumor in this gland by 2 times.
• Snus can contribute to development
  breast cancer in women under 55 years of age.
• Reception
  sucking tobacco during pregnancy is strictly prohibited, so
  how it can cause premature birth and negatively affect
  fetal development.
• Reception
  sucking tobacco leads to the appearance of nicotine in the blood and promotes
  spasm and vasoconstriction.This condition increases the risk of developing
  ischemic heart disease, arterial hypertension, atherosclerosis and
  strokes.
• Snus severely damages teeth.
  Constant inflammation of the gums, a destructive effect on the enamel – all these
  factors increase the likelihood of developing caries and periodontal disease,
  contribute to darkening and destruction of small molars, incisors and
  fangs.
• Reception
  sucking tobacco is accompanied by strong salivation and saliva,
  mixed with nicotine and carcinogens, it enters after swallowing
  digestive organs.Because of this, the mucous membranes of the stomach and intestines, as well as
  when ingesting 90,033 chewing tobacco , are constantly exposed to
  irritation, become inflamed and erosions and ulcers can form on them.
  Entering the digestive system of carcinogens increases the likelihood
  the development of stomach and intestinal cancer.
• Research
  show that avid snus aficionados can take up to 3 cans
  sucking tobacco. If it contains sugar, then such an intake in
  the body increases the risk of developing diabetes at times.
• Snus contains nicotine and its
  use negatively affects potency. When taking a sucking
  of tobacco, the blood vessels are narrowed, and men cannot get enough
  the genital organ is filled with blood. According to statistics, regular and frequent
  the use of any tobacco products increases the risk of developing impotence by
  65%. In addition, sperm quality and the risk of problems with
  conception increases by 75%.

The risks of taking snus are extremely high and difficult to minimize.Topics
more that the dependence on sucking tobacco is much stronger than smoking
cigarettes. Perhaps its only advantage over smoking tobacco is
the fact that it does not burn, and does not enter the body contained in tobacco
smoke tarry carcinogens that inflict strong blows on the tissues of the lungs.
However, this fact cannot be an excuse for taking chewing tobacco or
snus. Even in this form, taking tobacco products causes irreparable harm.
the body.

WHAT STILL DANGEROUS SNUCE FOR TEENAGERS?

Snus is especially popular among teenagers and young people.Among this category
it is considered not only safe but also fashionable. In addition, some
teenagers begin to use snus, since its intake is not so noticeable
to parents like smoking cigarettes.

Sucking tobacco is especially dangerous in adolescence,
since the body is not yet fully formed. Snus inflicts
such harm:

• deceleration
  and growth arrest;
• violation
  cognitive processes;
• deterioration
  concentration of attention and memory;
• increased
  irritability and aggressiveness;
• attenuation
  immunity and increased susceptibility to infectious diseases;
• more
  high risk of developing oncological diseases of the oral cavity, stomach and
  pancreas.

Some studies show that almost all adolescents who have started
their tobacco experience from snus for four years they start smoking cigarettes. This is
means that the harm from smoking is added to all the above risks
tobacco.

SNUCE DISCLAIMER

Quit smoking cigarettes , and even more so refuse to take snus, very
not easy. Many nicotine addicts need more than one to be successful.
attempts to combat tobacco addiction.Independent attempts in only 5%
cases are successful, and this form of addiction is considered one of the most
invincible. Parting with her is possible only with an integrated approach and carrying out
psychological rehabilitation.

Snus addiction is even stronger than smoking. To overcome it
special treatment needed:

• nicotine replacement
  therapy – transdermal patches and chewing gums;
• anti-nicotine
  drugs – Cytisine, Champix, Bupropion, etc.;
• psychotherapy
  – group and individual lessons;
• hypnosis
  – the effect on the psyche in a state of hypnotic trance strengthens
  the mindset to quit tobacco use;
• acupuncture
  – impact on specific points in order to develop aversion to nicotine.

The choice of treatment for nicotine addiction is determined individually and
depends on many factors: experience and method of taking tobacco, characteristics
character and personality, age.The effect of treating snus addiction or smoking
must be consolidated by the psychological rehabilitation of the addict. Such a complex
approach helps to reduce the likelihood of recurrence in the future and form a stable
setting to quit using tobacco products in any form.

Psychiatrist-narcologist
GBUZ JSC Skovorodinsky CRH
Bondarenko N.A

instructions for use, analogs, composition, indications

Adults and the elderly

The dosage is selected individually depending on the intensity of smoking.

Usually:

– chewing gum “Nicorette®” with a dosage of 2 mg should be used when smoking less than 20 cigarettes a day or when smoking the first cigarette 30 minutes after waking up;

How to use Nicorette® chewing gum

Chewing gum “Nicorette®” should be used in all cases when there is an irresistible urge to smoke, in accordance with the following scheme:

Slowly chew the gum for about 30 minutes until a strong taste or mild burning sensation appears,

stop chewing and leave the gum between the inside of the cheek and the gum,

after the disappearance of taste and / or burning sensation, slow chewing should be resumed.

Complete smoking cessation

You should chew only one pad at a time, stop smoking.

With a complete cessation of smoking, the dose of chewing gum per day is determined by the degree of dependence on nicotine, but usually it is 8-12 pieces per day and should not exceed 15 pieces per day. Chewing gum in the indicated dose should be used for at least 3 months, after which the daily used number of gum should be gradually reduced until it is completely canceled.The gum is canceled when the daily dose is 1 – 2 pieces per day.

Regular use of chewing gum for more than 12 months is usually not recommended , however, some people require longer therapy to avoid resuming smoking.

Reduction in the number of cigarettes smoked

Chewing gum should be used between smoking episodes to lengthen the intervals between smoking cigarettes in order to minimize cigarette consumption.If within 6 weeks it was not possible to achieve a decrease in the daily consumption of cigarettes, you should seek the help of a specialist.

You should try to quit smoking as soon as you feel ready for it, but no later than 6 months after starting therapy. If you have not been able to make a serious attempt to quit smoking within 9 months after starting therapy, you should consult a specialist.

Regular use of gum for more than 12 months is usually not recommended, however, some people require longer therapy to avoid resuming smoking or returning to their previous tobacco use.

The simultaneous provision of medical counseling and the provision of psychological support usually increases the effectiveness of therapy.

Temporary smoking cessation

Chewing gum can be used during periods when you need to refrain from smoking, for example, when you are in places where smoking is prohibited, or in other situations when you need to refrain from smoking.

Under the age of 18, chewing gum may only be used on the recommendation of a doctor!

Do not exceed the indicated dose!

It is recommended to carry Nicorette® chewing gum with you to use it whenever you want to smoke.

State Healthcare Institution “Children’s Clinical Medical Center of Chita”

Tobacco dependence (like addiction to drugs) is a complex combination of biochemical effects on the body, learned behavior, genetic and social factors. That is why effective treatment of smoking requires an integrated approach to overcoming pathological cravings for cigarettes.

What is addiction

The World Health Organization defines addiction as the repeated use of a psychotropic substance or drug to such an extent that a person:

• periodically or chronically is in a state of intoxication (poisoning),
• forced to constantly take a certain substance (repeat the act of smoking),
• has difficulty voluntarily stopping or changing substance use,
• seeks to obtain psychotropic substances by any means,
• often suffers from withdrawal symptoms (withdrawal syndrome or “breakdown”) when taking a break in substance use.

Nicotine properties

Nicotine creates a feeling of satisfaction. Smokers use cigarettes to maintain mental alertness and control their mood, so quitting can be stressful. Paradoxically, although nicotine is primarily a stimulant, its use can both invigorate and help to relax. The addictive effect of smoking is related to the ability of nicotine to trigger the release of dopamine, a substance produced by the brain that is associated with feelings of pleasure.However, for a long time, nicotine suppresses the brain’s ability to experience pleasure. Therefore, each time a smoker needs more and more psychotropic substances to achieve the same level of satisfaction. Smoking can be called a form of self-medication: further smoking relieves the withdrawal symptoms that occur soon after the effect of nicotine disappears.

Complexity of smoking addiction treatment

Perhaps one of the clearest indicators of nicotine addiction is the discrepancy between the desire to quit and the success rate of treatment.Studies have repeatedly shown that the majority of smokers (about two thirds) strive to quit the habit, however, the percentage of those who succeed is very low.

Survey ₁ “Behavior and attitudes associated with smoking” 2008/09 showed that 26% of surveyed smokers tried to quit the habit in the previous year, and about 21% of smokers had attempted a year or more before ¹ . The power of addiction is also confirmed by the fact that some smokers cannot get rid of nicotine addiction even after undergoing surgeries due to smoking-related illnesses.A 1995 study found that about 50% of lung cancer patients resumed smoking after undergoing surgery. Among smokers who have had a heart attack, at least 70% return to smoking within a year. More recent research confirms the difficulty smokers face in quitting their habit, even after learning about a life-threatening disease.

Symptoms of nicotine addiction

• Constant need to smoke.The key factor is the level of the person’s need for cigarettes. Most smokers smoke daily. Other indicators of nicotine addiction include the time from waking up to smoking the first cigarette. In 2010, 90,648 1,90,649 among smokers of all ages, 14% reported lighting a cigarette within five minutes of waking up. Heavy smokers are much more likely to gravitate towards a cigarette immediately upon waking: 32% of those who smoke more than 20 cigarettes a day smoke within five minutes of waking up, compared with 4% of those who smoke less than 10 cigarettes a day ¹ .
• The presence of withdrawal symptoms (withdrawal syndrome). Another indicator that indicates the need to treat nicotine addiction with drugs that replace nicotine is the emergence of “withdrawal syndrome”. It occurs in smokers immediately after quitting cigarettes. Typical symptoms after smoking cessation / reduction in people not using specific nicotine addiction medications are: cravings for cigarettes, irritability, anxiety, difficulty concentrating, anxiety, sleep disturbances, heart rate fluctuations, and increased appetite or weight gain.These symptoms can be reduced or relieved with nicotine replacement therapies such as patches, chewing gum, pills, or other drugs to treat nicotine addiction.

Genetic predisposition to nicotine addiction

American scientists have found ₁ that some smokers may have a predisposition to nicotine addiction due to the influence of the gene responsible for converting nicotine ¹ .At the same time, smokers with a genetic predisposition are more likely to become heavy smokers than people without it: they are more addicted to nicotine and are less likely to get rid of the addiction to smoking, even with appropriate treatment. Having a predisposition does not mean that a person is likely to become a smoker, but those with such a gene are more likely to become addicted to nicotine. In addition, smokers with a CYP2A6 gene mutation tend to smoke less because nicotine is cleared more slowly from the body.Conversely, non-mutated smokers tend to smoke more to compensate for the faster elimination of nicotine from the body. It is more difficult for such people to get rid of nicotine addiction.

Nicotine and harm reduction

Although it is the nicotine in tobacco products that causes addiction to cigarettes, most of the harm from smoking is caused by toxins and carcinogens contained in tobacco smoke and combustion products. Pure nicotine, free of harmful impurities, can be used to quit smoking.It can also help smokers to reduce or quit smoking cigarettes temporarily, for example, if the smoker is forced to abstain from smoking during a long flight or hospital stay. Experts support the initiative to use nicotine-containing drugs to help smokers to relieve cravings and reduce symptoms of withdrawal symptoms. The use of drugs for the treatment of nicotine addiction can help to gradually reduce the number of cigarettes smoked, and then completely quit smoking.

Smoking is the leading cause of many fatal diseases and premature deaths. The World Health Organization estimates that about 6 million people die from tobacco use worldwide each year. The problem is expected to worsen as the figure rises to 7 million by 2020 and more than 8 million by 2030. Smoking harms the health of almost the entire body, dramatically reducing the quality and duration of life.

What harmful substances are contained in cigarettes

A cigarette may seem harmless enough – tobacco leaves in plain white paper. But when burning, a dangerous mixture of about 4,000 chemicals is released, including the following.

• Resins. These are compounds of particulate matter that a person inhales when they light a cigarette. Smoking is dangerous because many of the resins that make up the mixture are carcinogenic. When the resin settles, it forms a sticky brown substance that remains not only on the teeth and fingers, but also in the lungs of smokers.
• Arsenic. It is the most dangerous chemical in cigarettes. One of the most serious health effects of smoking associated with arsenic is cancer. Arsenic also damages the heart and blood vessels.
• Benzene. It is a solvent used to make other chemicals, including gasoline. It is well established that benzene can cause cancer. It is he who leads, at least, to every tenth death from leukemia due to smoking.
• Formaldehyde. A foul-smelling chemical that is used to kill bacteria, preserve corpses, and produce other chemicals. According to most experts, it is formaldehyde ¹ that causes such consequences of smoking as diseases of the lungs and respiratory tract.
• Polonium. It is a rare radioactive element with alpha radiation. According to studies, the dangers of smoking are the following: if a person smokes one and a half packs of cigarettes a day, he receives radiation exposure equal to 300 chest X-rays per year ¹ .
• Other substances. Smoking is harmful because a large amount of other toxic substances contained in tobacco smoke pass through the blood vessels through the entire body, leading to negative results.

What happens in the body when you smoke

The chemicals in a cigarette affect the entire body. It is for this reason that smoking causes the development of a large number of diseases, including several types of cancer.

Your lungs and airways

The problem of smoking is associated with the fact that inhaled smoke damages the tissues of the respiratory tract and lungs.Chemicals such as nitric oxide are harmful and constrict the bronchi, making breathing difficult. Hydrogen cyanide, carbon monoxide and ammonia interfere with the natural cleaning mechanisms that remove toxins from the lungs and respiratory tract. The harmful chemicals, bacteria and viruses that you breathe are deposited in your bronchi and lungs. In the lungs, carcinogenic and other toxic substances contained in tobacco smoke are absorbed into the bloodstream, and are carried to other organs and systems.

Your heart and blood vessels

The answer to the question “what harm does smoking cause?” the presence of toxic substances in tobacco (arsenic, hydrogen cyanide, etc.), which can affect the cells of the heart and blood vessels, is already in itself. Nicotine and carbon monoxide constrict blood vessels. Smoking is also associated with increased blood cholesterol levels and an increased risk of blood clots. Substances such as carbon monoxide and nitric oxide reduce the ability of blood hemoglobin to carry oxygen.For this reason, smoking leads to a decrease in the amount of oxygen (or hypoxia) entering the brain and other organs, affects the reduction in energy production and causes a noticeable deterioration in well-being.

What diseases develop due to smoking

Various types of cancer. One of the main dangers of smoking is cancer of the lungs, trachea and bronchi, upper respiratory tract, larynx, esophagus, bladder, pancreas. The kidneys, stomach, cervix also suffer from this disease; leukemia and cancers of unspecified localization may develop ² .

Diseases of the cardiovascular system. These are the consequences of smoking, such as ischemic heart disease (eg angina pectoris), Buerger’s disease (severe cardiovascular disease), peripheral vascular disease (obliterating endarteritis).

Diseases of the respiratory system. Causing harm to the body, smoking can complicate the course of bronchial asthma, chronic rhinitis (inflammation of the nasal mucosa), SARS and influenza, tuberculosis, and causes the development of chronic obstructive pulmonary disease.

Diseases of the stomach / digestive system. Due to the effect of smoking on the body, colon polyps, Crohn’s disease (chronic inflammatory bowel disease), gastric ulcer and duodenal ulcer develop.

Diseases of the oral cavity. Acute necrotizing ulcerative gingivitis (gum disease), tooth loss, and discoloration of the enamel can be a clear confirmation of the harm of smoking to the body.

Diseases of the musculoskeletal system. Smoking affects the health of ligaments, tendons and muscles. Under the influence of nicotine, pain in the neck and back occurs, osteoporosis develops (in men and women), rheumatoid arthritis (in heavy smokers).

Eye diseases. Evidence of the harm of cigarette smoking is the development of diseases such as cataracts, macular dystrophy (damage to the retina), nystagmus (abnormal eye movements), optic neuropathy (fraught with loss of vision), ocular histoplasmosis (fungal eye infection), tobacco amblyopia (loss of vision) ), diabetic retinopathy (retinal vascular damage due to diabetes mellitus), optic neuritis.

Diseases of the reproductive system. Common effects of smoking are decreased fertility in women (by 30%), menopause (starts, on average, 1.74 years earlier), decreased male fertility (impotence, decreased sperm count and motility, decreased ability of sperm to enter the egg) …

Other diseases. The effects of smoking on the body can cause depression, hearing loss, multiple sclerosis, type 2 diabetes.

How smoking affects your appearance

Leather. First, exhaled tobacco smoke dries out the surface of the skin, especially the skin of the face. Secondly, the problem of smoking is associated with constriction of blood vessels, which reduces the amount of blood flowing to the skin – in this regard, it is deprived of a significant part of oxygen and essential nutrients. Skin damaged by tobacco smoke has a grayish, emaciated appearance. Darkening around the eyes is also a possible consequence of smoking.Smokers over the age of 40 often have the same number of facial wrinkles as non-smokers over the age of 60. Smokers, compared to nonsmokers, have a two to three times higher risk of developing psoriasis.

Fig. For the endocrine system, smoking is harmful because the distribution of body fat in smokers deviates from the norm. In smokers, fat tends to accumulate around the waist and upper torso, rather than on the thighs. For this reason, smoking results in a disproportionate waist-to-hip ratio.

Oral cavity. Halitosis (bad breath), stained teeth and gums are perhaps the most famous and obvious consequences of smoking. Tobacco use affects the development of periodontal disease, gingivitis (inflammation of the gums), bad breath, and tooth loss. More than half of adult cases of periodontal disease develop due to smoking.

There are various ways to quit smoking today.Some of them are more effective, others less. Regardless of the chosen way of dealing with nicotine addiction, it is important to remember that it can be not only physical, but also psychological. Therefore, the best way to quit smoking is a holistic approach to combating the addiction.

Why you should quit smoking

When you use quick ways to quit smoking, you can notice positive changes in your body within a few hours after quitting cigarettes.Other improvements in health status appear over several years depending on the “experience” of smoking.

How to find an easy way to quit smoking

Many people continue to smoke not because of a conscious choice, but because of a formed addiction. It occurs due to the fact that nicotine quickly enters the brain with every puff. But the presence of addiction does not mean that it is impossible to get rid of it. Smokers do have a strong craving for cigarettes, but they can and should be overcome. Anything that can help resist or reduce cravings can be an effective way to quit smoking.

More than a third of smokers make at least one attempt to quit smoking a year, and only 2-3% of them manage to restrain themselves for a long time. Some attempts to quit cigarettes, depending on the way to quit smoking, will quickly be successful, while others will not. However, it is clear that smoking less tobacco per day, quitting the cigarette immediately after waking up, and avoiding psycho-emotional stress are favorable factors for success. In addition, different ways to combat smoking can be more or less effective for different degrees and patterns of addiction.

Ways to combat physical addiction

With physical dependence, there are various ways to quit smoking – immediately or gradually. To get rid of the addiction without “stress” for the body, you can use nicotine patches, tablets and chewing gums in either case. Let’s talk in more detail about different ways to quickly quit smoking.

• Switch to other types of tobacco. Some smokers simply switch to light cigarettes, chewing tobacco, pipes or shisha in the hopes that they represent a less dangerous form of smoking.However, there is no harmless tobacco product. Switching to other types of tobacco is not the best way to quit smoking, as there is no cessation of addiction. As a rule, the number of “light” cigarettes smoked per day only increases to obtain the usual dose of nicotine, and as a result, the amount of inhaled combustion products increases, which cause even greater harm to health. And the health risk of inhaling smoke from pipe or hookah is significantly increased compared to smoking regular cigarettes ₁ .
• Switching to other sources of nicotine. Electronic cigarettes are marketed as a quick and easy way to quit smoking, but so far there has been very little research and no official data on their safety. Many smokers use these devices to quit addiction. However, there is no medical evidence that e-cigarettes are an effective way to quit smoking ₁ .
• Nicotine replacement therapy.Nicotine-containing drugs include chewing gums, patches, and tablets. These smoking cessation strategies can help you get rid of addiction in 12 weeks *. Nicotine replacement therapy is designed to reduce the craving for smoking by reducing the symptoms of withdrawal symptoms due to the replacement of nicotine contained in cigarettes. By reducing the symptoms of nicotine withdrawal, it becomes easier to transition from reducing the number of cigarettes smoked to quitting tobacco altogether. Clinical studies have shown that this way of quitting smoking increases the chances of quitting cigarettes by 90% ² .It is widely believed among smokers that nicotine is the cause of cancer, and therefore it is also unsafe to take nicotine-containing drugs. But lung cancer and other diseases associated with smoking are most often caused not by nicotine, but by tar and other toxic substances contained in cigarette smoke. Studies have shown that people who choose this easy way to quit smoking and have been using nicotine replacement therapy for a long time (up to 1 year) did not develop health problems.
  * Applies to NICORETTE®

preparations

• Other drug treatment. In addition to nicotine replacement therapy, there are various ways to control smoking with other drugs, most of which are prescription drugs and should only be prescribed and used under medical supervision.

Ways to overcome psychological dependence

For addiction, you can try the following ways to quit smoking.

• Sports. Regular and moderate exercise stimulates the body’s production of pleasure hormones – endorphins. Some people get a similar enjoyment from cigarettes. So you can simply replace smoking with sports.
• The book “An easy way to quit smoking.” To date, many smokers have given up cigarettes with the help of this book by Allen Carr. It is small in volume and you can keep smoking until you finish reading it. For those few smokers who are not physically addicted to cigarettes, you can try this simple quit smoking method.
• Alternative methods (coding, acupuncture). These methods of quitting smoking are not officially approved, their effectiveness has not been confirmed.

Tips for reinforcing motivation

1) Calculate how much money you can save on cigarettes, and motivate yourself with plans about how you will spend it.
2) Set the date! Some make a promise to themselves to quit smoking before the New Year, but any day will do.Select a date when you will quit smoking – this will help you mentally prepare to quit smoking once and for all.
3) List the reasons why you want to quit smoking. Review it regularly to support your resolve.
4) The urge to smoke can last up to five minutes, so make a list of five-minute things to do in advance that you can do before the craving for a cigarette wears off.
5) Spend more time with non-smoking friends to avoid the temptation to smoke for company.
6) Think pleasant. If you’re tempted to smoke, think of something other than a cigarette — a great day in nature, hanging out with loved ones, or a fond memory. The less you think about smoking, the easier it will be for you to abstain from it.

Tips for improving well-being

1) Do not sit idly by. As soon as you feel the urge to smoke, take your mind off it with an activity. In the evenings, cigarette cravings can be particularly acute, so find a new hobby, design, or exercise.
2) You have acted with your hands and mouth while smoking, so it’s good to find a temporary replacement for this habit. For example, you can chew gum or drink more water.
3) Determine what triggers your smoking cravings.
Alcohol is one of the main triggers, so try to cut back when you quit smoking.
4) Try nicotine replacement therapy.
NICORETTE ^® offers a wide range of NRT products to help you fight cigarette cravings and support your willpower to quit smoking.