Doc can help wean her off Nicorette

Sat., Sept. 25, 2004

Peter Gott United Media

Dear Dr. Gott: My wife was a two-pack-a-day smoker until she kicked the habit 11 years ago with the help of Nicorette chewing gum. Although I am proud of her for quitting cigarettes and grateful that she is now avoiding the health problems of smoking, I fear she may have traded one bad habit for another. She chews 10 to 20 pieces of the gum daily. Now I am concerned that there may be serious effects from the gum itself. Are my fears justified?

Dear Reader: Despite reassurances to the contrary by tobacco-company executives, nicotine is clearly addictive.

I am glad to hear that your wife has stopped smoking, because the health risks of cigarettes are substantial and include heart disease, cancer, stroke and other serious ailments. These consequences are believed to be due to the non-nicotine ingredients in tobacco smoke — principally tars, carcinogens and carbon monoxide.

Nonetheless, as you suspect, nicotine is far from harmless. The drug causes hypertension, constriction of arteries (thereby worsening various vascular disorders), rapid pulse and chemical imbalances in the body. Acute nicotine withdrawal produces a wide array of symptoms, including craving, nervousness, sleep disturbances, anxiety, swings in mood and weight gain.

Because of the effects of nicotine, Nicorette’s manufacturer advises that the gum not be used by people with heart disease, angina, hyperthyroidism, peptic ulcer, hypertension or peripheral vascular disease. In addition, the product should not be used for longer than six months.

To wean patients off Nicorette, the manufacturer recommends the following steps:

• Reduce the number of pieces chewed by one a day every week.

• Decrease chewing time with each piece from the customary 30 minutes to 15 minutes. This releases less nicotine.

• Replace standard Nicorette gum with the half-strength variety, which contains two milligrams of nicotine instead of the usual four milligrams.

• Substitute sugarless gum (one a day every week).

I agree that your wife has chewed too much Nicorette gum for too long. Your wife’s physician should be both notified of her habit and involved in its solution. He can help her gradually reduce her dependence on the gum.

To give you related information, I am sending you a copy of my Health Report “Mental and Substance Abuse.” Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.

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