Combining the Nicotine Patch and Nicotine Gum or Nicotine Lozenge
No question: Compared to going cold turkey, using nicotine replacement therapy — such as the nicotine patch, gum, and lozenge — can dramatically increase your chances of successfully quitting smoking. But you can boost your odds even more by combining the patch with either the gum or the lozenge.
The patch delivers a steady stream of nicotine for 24 hours, so you get long- acting, consistent relief from withdrawal symptoms, such as headaches and irritability. Meanwhile, the gum or lozenge delivers a small amount of nicotine within 15 minutes, helping you manage tough situations and keeping your mouth busy as you ride out the cravings. Used together, the patch and the gum or lozenge can provide much better relief from nicotine cravings that if used alone.
Don’t worry: Combining medications is unlikely to give you too much nicotine. For one thing, nicotine itself is the least harmful ingredient in tobacco. It’s the other 7,000 chemicals that combine to damage virtually every organ in your body. The patch, gum, and lozenge — even in combination — typically deliver less nicotine than cigarettes do for most smokers, and as the weeks pass, you will gradually wean yourself off nicotine completely. Nicotine replacement products give you just enough nicotine to minimize cravings as you master behavioral strategies to overcome your addiction.
Nicotine patches, gum, and lozenges are sold over the counter and are available at most drug stores. Together, a one-day supply of the patch and gum or lozenge costs about the same as a pack of cigarettes, depending on the price of cigarettes in your area.
The key to successful combination therapy is using your medications correctly. Here’s how to get the most out of these useful tools.
The patch is worn like a Band-Aid on your upper body, above your waist but below your neck. Press the patch in place by holding it firmly for 10 seconds. It’s as simple as that.
Each morning, take off your old patch and put on a new one. To minimize skin irritation, don’t put the patch in the same spot for at least seven days.
The nicotine in the patch starts being absorbed into your bloodstream as soon as you apply it, but it takes up to four hours to reach peak blood levels. So, supplementing the patch with a piece of gum or a lozenge is particularly helpful in the mornings. You get a fast-acting dose of nicotine to help you deal with cravings before the patch kicks in.
Nicotine gum allows you to increase or decrease the amount of nicotine you get until you find just the right amount to help you manage your cravings.
When you use the gum with the patch, start by using one piece of gum every one to two hours or whenever you get the urge to smoke. Don’t exceed 24 pieces of gum in a 24 hour period.
Nicotine gum isn’t like regular chewing gum. It must be chewed in a very specific way so that you don’t swallow the nicotine. Chew the gum slowly several times, and then “park” it in the corner of your mouth so that the nicotine can be absorbed through the tissues there. In a few minutes, chew a few more times and park the gum again. This method ensures that nicotine won’t enter your bloodstream, where it would be neutralized by stomach acids. Spit the gum out after 30 minutes.
Don’t drink coffee, tea, juices, colas, or any other acidic beverage while you’re chewing or for 15 minutes before or after you chew the gum. The acid in these drinks will prevent your mouth from absorbing the nicotine.
Like the gum, the nicotine lozenge lets you adjust the amount of nicotine you get until you hit your sweet spot.
When you use the lozenge with the patch, start by using one lozenge every one to two hours or whenever you get an urge to smoke. Don’t exceed 24 lozenges in a 24 hour period.
Like the gum, the nicotine lozenge must be used in a specific way: Put a lozenge in your mouth and let it dissolve. Do not chew or swallow the lozenge; otherwise, you’ll swallow nicotine, and it will end up in your stomach rather than getting absorbed through your mouth tissues. Move the lozenge around your mouth from time to time, and then “park” the lozenge in same way you would a piece of nicotine gum.
Don’t drink acidic beverages when you have a lozenge in your mouth or for 15 minutes before or after you have a lozenge. The acid in these drinks will prevent your mouth from absorbing the nicotine.
Side Effects of the Patch, Gum, and Lozenge
Side effects of the nicotine patch, gum, and lozenge are usually minor.
Some people experience skin irritation or soreness in the area the patch is applied. To prevent this, find a new spot each day to place your patch, always above your waist and below your neck. When you remove a patch, wash the area with soap and water to remove any adhesive. If you continue to experience irritation, talk to a pharmacist about using hydrocortisone cream.
As for side effects of the gum and lozenge, nausea and upset stomach are usually signs of swallowing nicotine, so review instructions for using the gum and lozenge correctly. If you have a headache, you may be experiencing withdrawal from not getting enough nicotine. Or, you may be getting too much nicotine. Talk to your doctor or pharmacist about adjusting your dose of the patch, gum, or lozenge.
All nicotine replacement products can sometimes result in vivid dreams, interfere with sleep or cause minor nausea or headaches. Try removing the patch one hour before bed or not using the gum or lozenge in the hour preceding bed to avoid vivid dreams or trouble sleeping.