Can't stop chewing Nicorette (nicotine gum)!

Dear The idiot., 

Quitting smoking is no small feat, and since you've successfully quit and stayed away from cigarettes for the past twelve years, you may have success with smoking's intended cure, nicotine replacement therapy (NRT). So no, it wouldn’t be recommended to start smoking again! Although both Nicorette, a type of nicotine gum, and cigarettes contain nicotine, the gum is still the lower risk choice since it doesn’t contain tobacco or any of the other harmful additives in cigarettes. But while gum is better for you than smoking, there may still be damaging side effects if taken for too long or in dosages that exceed what’s recommended. Depending on your chewing habits, you might consider speaking with a health care provider about how to reduce your nicotine gum usage without experiencing those pesky withdrawal symptoms. In the meantime, this response may give you more information about nicotine gum to chew on! 

As you may know, Nicotine gum serves as a way for people who smoke to gradually wean themselves off cigarettes. Compared to cigarettes, nicotine gum contains smaller amounts of nicotine that take longer to be released in the body — this helps reduce the likelihood of experiencing withdrawal symptoms. By gradually chewing less and less gum over approximately twelve weeks, the body acclimates to decreased nicotine levels, ultimately relieving the person of their nicotine addiction. As your chewing has surpassed the twelve-week mark, you may find that you may experience side effects such as mouth and jaw problems, nausea, heartburn, and mouth blisters. It's also possible there may be an increased risk of developing cancer, but thus far the research is unclear.  

How do you use nicotine gum when you chew it? Do you chew it like regular gum? Do you chew multiple pieces in a row? Or do you use the often recommended “park and chew” method? This method involves biting down on the piece of gum until you get a tingling feeling (the release of nicotine) and then “park” the piece of gum between your teeth and your cheek. Once the tingling wears off, you start chewing again until the sensation occurs. This process lasts about 30 minutes. The purpose of the “park and chew” method is to help the nicotine be quickly absorbed into your bloodstream via blood vessels in your mouth; if you chew without parking, you end up swallowing your nicotine-infused saliva, which may result in a longer wait time until the nicotine hits your brain. Depending on your goals and current methods of chewing, this method may either help or hinder you in your progress towards weaning yourself off the gum. You might want to experiment a bit to see what works best for you! Whichever way you go though, it’s not recommended to chew more than 24 pieces of gum per day. 

Even though you've been chewing the gum for longer than the recommended twelve weeks, it’s not too late to try to temper yourself off the stuff. Some tips to help you reduce use of nicotine gum may include: 

• Gradually decrease the total number of pieces you use per day. You might find it helpful to substitute regular sugarless gum for nicotine gum, so you still get that chewing habit without all the nicotine.  
• You could consider switching to the two-milligram gum if you normally chew the four-milligram gum. 
• Gradually decrease the amount of nicotine you consume per piece of gum by chewing it for shorter amounts of time. 
• Consider stopping use of nicotine gum altogether when your craving for nicotine is satisfied by one or two pieces of gum per day. 

You might also consider trying a different NRT (such as the patch, inhalers, nasal sprays, or lozenges) to see if a different one is helpful in weaning off the gum. Similarly, there are a few prescription medications that are sometimes prescribed for nicotine addictions, which may or may not be helpful for your gum situation. To help you in this process, it might also be helpful to spend some time reflecting on your experience quitting cigarettes twelve years ago. What helped you quit all those years ago? Did you identify any triggers that increased the urge to smoke, and how did you learn to avoid them? What was the most challenging part about quitting, and what helped you overcome it? Who helped support you during that time — maybe a family member, friend, or trusted health care provider? You might find that some of the knowledge, skills, and support structures that helped you in the past could also be useful in the present. 

Nicotine gum manufacturers recommend that if you feel the need to continue using the gum after twelve weeks, it may be beneficial to speak with a health care provider about your experiences. Another potential option is Nicotine Anonymous, a 12-step group program that helps people kick the addiction. It's great that your dedication to your family has helped you stay clear of many vices, including smoking. By drawing on the same dedication that's kept you smoke-free for over a decade, you could soon have this lingering vice out of the way as well.