Using Nicotine Lozenges for Quitting Smoking

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: 4mg
• First 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 hours
• Weeks 7 to 9: One lozenge every two to four hours
• Weeks 10 to 12: One lozenge every four to eight hours

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:

• Heartburn
• Hiccups
• Indigestion
• Nausea
  
• Sore 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 palpitations
• Mouth sores
• Severe throat irritation
• Symptoms of nicotine overdose, which may include dizziness, vomiting, confusion, blurred vision, and feeling weak
• Symptoms 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:

• Diabetes
• An overactive thyroid
• Blood vessel conditions like Bruegger's disease
• An adrenal gland tumor
• Stomach ulcers
• Had 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.

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.

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.