Addiction Nicotine Addiction Coping and Recovery Using Nicotine Lozenges for Quitting Smoking Guidelines for Using Lozenges as a Quit Aid By Terry Martin Terry Martin Facebook Twitter Terry Martin quit smoking after 26 years and is now an advocate for those seeking freedom from nicotine addiction. Learn about our editorial process Updated on October 08, 2021 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Richard Fogoros, MD Medically reviewed by Richard Fogoros, MD Richard N. Fogoros, MD, is a retired professor of medicine and board-certified internal medicine physician and cardiologist. He is Verywell's Senior Medical Advisor. Learn about our Medical Review Board Print Verywell / Gary Ferster Table of Contents View All Table of Contents Pros and Cons Brands and Strengths Dosing Side Effects Special Precautions How to Decide The nicotine lozenge is a nicotine replacement therapy (NRT) product that comes in the form of a small, candy-like tablet in flavors like cinnamon, fruit, and mint. When a nicotine lozenge is placed in the mouth and allowed to dissolve over the course of 20 to 30 minutes, nicotine is absorbed into the bloodstream, relieving short-term cravings to smoke. You cannot smoke while using nicotine lozenges, so many people use them as a quit aid, though there are many things you should know and understand about these lozenges before using them to help you quit smoking. Pros and Cons Nicotine lozenges offer quick relief from cravings that are part of nicotine withdrawal. However, they are not a fail-safe solution. Lozenges should only be used on an as-needed basis, but since they are similar to candy—both in taste and form—the potential to misuse this quit aid is significant. While you don't need a doctor's prescription for nicotine lozenges, they are a serious over-the-counter medication that must be used exactly as directed, and you need to carefully wean yourself off of them in the amount of time suggested. Also, while you can use them in the moment for fast relief, that also means you have to keep them readily available and use them throughout the day which can be a drawback. According to the 2020 Surgeon General report on smoking cessation, one additional advantage to using a lozenge is that because it's an oral treatment, it can provide a physical substitute for a cigarette. Brands and Strengths Nicotine lozenges are available in different brand names as well as generic products. Brand names associated with the nicotine lozenge include Commit, Nicorette, and Nicorette Mini Lozenge. All of these brands are made by GlaxoSmithKline and come in multiple strengths: Commit and Nicorette Lozenges come in two strengths: 2mg and 4mg.Nicorette Mini Lozenges are also available in 2mg and 4mg strengths, but they are smaller in size and dissolve up to three times faster than regular Nicorette lozenges. Dosing You can choose the right lozenge strength for based on when your first cigarette of the day typically was and following these guidelines: First cigarette within 30 minutes of waking: 4mgFirst cigarette more than 30 minutes after waking: 2mg Nicotine lozenges should be used in the following dosages: Weeks 1 to 6: One lozenge every one to two hoursWeeks 7 to 9: One lozenge every two to four hoursWeeks 10 to 12: One lozenge every four to eight hours Do not use more than five lozenges in six hours or 20 lozenges in a 24-hour period. You should stop using nicotine lozenges by the end of 12 weeks. If you have trouble stopping, consult your doctor. Because acidic foods and beverages can inhibit the absorption of nicotine through the lining of the mouth, lozenge manufacturers recommend waiting 15 minutes after eating before using a nicotine lozenge. Also, you cannot smoke or use any other NRT while using nicotine lozenges as you run the risk of a nicotine overdose. Side Effects Side effects that are commonly associated with nicotine lozenge therapy include: HeartburnHiccupsIndigestionNauseaSore throat If you experience any of the following severe side effects, stop using the nicotine lozenge and contact your doctor immediately: Irregular heartbeat or heart palpitationsMouth soresSevere throat irritationSymptoms of nicotine overdose, which may include dizziness, vomiting, confusion, blurred vision, and feeling weakSymptoms of an allergic reaction Continuing to smoke while using nicotine lozenges or using more lozenges than recommended could result in serious side effects. Special Precautions to Consider You should consult your doctor before using nicotine lozenges if any of the following conditions apply to you. Pregnancy Smoking is harmful to the fetus, so you should try to quit before you get pregnant, if possible. If you are not able to, it's important to work closely with your doctor to safely quit smoking during pregnancy. Using Certain Medications If you're using Chantix (varenicline), Zyban (bupropion), or medications for depression or asthma, your dosages may need to be adjusted once you stop smoking. People who smoke metabolize some medications more quickly than non-smokers, so be sure to let your doctor know about all medicines you're taking, including vitamins and supplements. Allergies Be sure to tell your healthcare provider if you are allergic to any medicines, foods, or other substances. To that end, if you experience any symptoms of an allergic reaction, such as a rash or swelling, while using nicotine lozenges, speak to your doctor immediately. History of Cardiac Issues Tell your doctor if you have heart disease, high blood pressure, angina, or have had a heart attack. Nicotine can raise your blood pressure and heart rate. Other Health Issues Speak to your provider before using nicotine lozenges if you have: DiabetesAn overactive thyroidBlood vessel conditions like Bruegger's diseaseAn adrenal gland tumorStomach ulcersHad seizures Special Diets If you are on a low-sodium diet or have phenylketonuria (PKU), a disorder that results in too much phenylalanine in the blood, be sure to tell your doctor. Nicotine is poisonous, and lozenges may contain enough nicotine to harm children or pets. Store them in a safe place, and contact Poison Control at 800-222-1222 in case of an overdose. How to Decide In order to decide if nicotine lozenges could work for you, consider what makes them unique. For example, like nicotine gum, they are available over-the-counter and taken orally. They also work to alleviate nicotine cravings as they happen; while the patch, for example, releases nicotine on an ongoing basis. According to the National Library of Medicine, some people may prefer having the control over timing and dose that comes with lozenges. Nicotine withdrawal has both physical and psychological symptoms. Physical withdrawal symptoms can include slower heart rate, digestive issues, and feeling more hungry, while on the other hand, you can also experience psychological symptoms such as a range of emotions such as irritability, grief, and depression. According to the American Cancer Society, NRT addresses some of the physical withdrawal symptoms. However, it's important to seek other support for the psychological issues that arise as well. Because addiction and recovery are complex, lozenges alone may not work for some people in their quest to quit smoking, but they could be a great tool to complement other treatments such as counseling or a quit program. The Centers for Disease Control and Prevention has a guide to help decide which quit smoking medicine may be best for you. It's also a good idea to go over any special considerations, such as your medical history, with your healthcare provider to decide if nicotine lozenges are a good option to help you stop smoking. Finally, to help your success, it's best if you're motivated to quit smoking before you start using nicotine lozenges. A Word From Verywell Nicotine lozenges can help you quit smoking, but keep in mind that it is a quit aid, not a miracle worker. The magic for success with smoking cessation lies within you, not a product. Work on developing your resolve to quit smoking one day at a time and be patient. Adding some online support to your quit program can improve the chance of long-term success with smoking cessation. The beauty of online help is that it is available to you 24/7. Time, determination, and support will help you kick the habit of smoking. Believe that, believe in yourself, and be willing to do the work it takes to quit. You'll find that you can quit smoking, just as others have. Best Non-Medical Ways to Quit Smoking 16 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Wadgave U, Nagesh L. Nicotine replacement therapy: An overview. Int J Health Sci (Qassim). 2016;10(3):425-35. Dautzenberg B, Nides M, Kienzler JL, Callens A. Pharmacokinetics, safety and efficacy from randomized controlled trials of 1 and 2 mg nicotine bitartrate lozenges (Nicotinell). BMC Clin Pharmacol. 2007;7:11. doi:10.1186/1472-6904-7-11 Centers for Disease Control and Prevention. Nicotine lozenge. Department of Health and Human Services. Smoking cessation: A report of the Surgeon General. Sukhija M, Srivastava R, Kaushik A. Pharmacokinetic characterization of three novel 4-mg nicotine lozenges . Int J Clin Pharmacol Ther. 2018;56(3):113-119. doi:10.5414/CP203097 Baker TB, Piper ME, McCarthy DE, et al. Time to first cigarette in the morning as an index of ability to quit smoking: Implications for nicotine dependence. Nicotine Tob Res. 2007;9 Suppl 4:S555-70. doi:10.1080/14622200701673480 Pack QR, Jorenby DE, Fiore MC, et al. A comparison of the nicotine lozenge and nicotine gum: An effectiveness randomized controlled trial. WMJ. 2008;107(5):237-43. Mills EJ, Wu P, Lockhart I, Wilson K, Ebbert JO. Adverse events associated with nicotine replacement therapy (NRT) for smoking cessation. A systematic review and meta-analysis of one hundred and twenty studies involving 177,390 individuals. Tob Induc Dis. 2010;8:8. doi:10.1186/1617-9625-8-8 Cleveland Clinic. Nicotine lozenges. National Library of Medicine. Nicorette medication label. National Library of Medicine. NICORETTE-nicotine polacrilex lozenge. MedlinePlus. Phenylketonuria. Centers for Disease Control and Prevention. Nicotine lozenge. MedlinePlus. Nicotine replacement therapy. McLaughlin I, Dani JA, De Biasi M. Nicotine withdrawal. Curr Top Behav Neurosci. 2015;24:99-123. doi:10.1007/978-3-319-13482-6_4 American Cancer Society. Dealing with the mental part of tobacco addiction.. Additional Reading GlaxoSmithKline. Frequently asked questions about Nicorette. GlaxoSmithKline. Nicotine Lozenges Dosing and Administration. Medline Plus. Nicotine lozenges. By Terry Martin Terry Martin quit smoking after 26 years and is now an advocate for those seeking freedom from nicotine addiction. 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