Guide to the nicotine lozenge including pros and cons and instructions on how to use.

nicotine lozenge
What is a nicotine lozenge?
The nicotine lozenge is one of the newest forms of nicotine replacement therapy products available on the market nowadays. It comes in the form of a sugar-free hard sweet, that you suck slowly in order to release the nicotine.

It is very similar to the nicotine microtab and the nicotine gum, in that the nicotine is absorbed through the lining of the mouth, which means that the nicotine is absorbed quicker into the bloodstream and therefore reaches the brain much faster as well.

The nicotine lozenge is available in two strengths, either 2mg or 4mg. If you smoke your first cigarette of the day within 30 minutes of waking up, then the stronger strength is more suitable for you.
The lozenges are available in a variety of flavours and each lozenge, which is the equivalent of one dose, contains 1mg of nicotine in the form of nicotine bitartrate dihydrate, the purest form of nicotine salt or powder.

Other ingredients that make up the nicotine lozenges are sodium bicarbonate, sodium carbonate, xanthan gum, peppermint oil and magnesium stearate.

The nicotine lozenge is most suitable for smokers with a medium nicotine dependency and is not recommended for those who smoke more than one and a half packets of cigarettes a day.

How do nicotine lozenges work?

A lozenge is placed in the mouth, between the gum and the cheek and sucked slowly until there is a strong taste of nicotine in the mouth. At this point stop sucking until the taste fades, resting the lozenge against the cheek. Continue to suck again when you cannot taste any nicotine in the mouth and suck the lozenge until it has completely dissolved. The lozenge should occasionally be moved from side to side in the mouth and the whole process should take about 20 - 30 minutes.

Upon sucking, small doses of nicotine are released and absorbed into the bloodstream through the lining of the mouth, from where it then travels quickly to the brain.

For this reason, lozenges are particularly efficient at helping with nicotine cravings and withdrawal symptoms as most of the nicotine contained in the lozenge is rapidly absorbed into the bloodstream and not lost. Quantities of nicotine will continue to be absorbed even after the lozenge has dissolved.

Smokers are advised to follow a schedule of 12 weeks when using the lozenges. During the first half of this period, 1 lozenge should be taken every 1 or 2 hours. For the following two weeks, weeks 7 - 9, this amount is reduced to one lozenge every 2 - 4 hours, thus gradually reducing the nicotine intake and finally, for the last two weeks, weeks 10 - 12, 1 lozenge should be taken every 4 - 8 hours.

By this time the nicotine intake is so low that the cravings and withdrawal symptoms should have subsided and you should be ready to stop the treatment altogether.

What is the success rate?

Using a form of NRT can double your chances of stopping smoking for good. A study that was carried out to test the efficacy of the nicotine lozenge proved that 46% of smokers who were given the 2mg strength lozenges did not smoke after a six week test period compared to 30% of smokers who were given a dummy lozenge. Results were similar for the 4mg strength lozenges, which were given to heavy smokers. 49% of those who took the nicotine lozenge did not smoke after the six weeks were up, whilst only 21% of those who were given the placebo had managed to quit. These percentages were more or less the same a year later.

Is this method safe?

As long as directions on how to take the lozenges are adhered to, they should be perfectly safe to use. Side effects may occur in some people but not necessarily in others.

No more than 20 lozenges should be consumed in one day, not more than five lozenges in six hours and only one lozenge is to be taken at one time. Any of the above may lead to a nicotine overdose where the smoker would experience symptoms such as palpitations and rapid heartbeat, dizziness, headache, nausea, vomiting, diarrhoea or weakness in the body.

The lozenges should be sucked slowly and gently, and not chewed or swallowed, as this may cause heartburn or indigestion.

People with or who have previously had any of the specific medical conditions outlined below should take care if taking any form of NRT and should consult the doctor beforehand:
  • Any form of heart disease - angina, heart attack
  • Stroke
  • Diabetes
  • Overactive thyroid
  • Stomach ulcer or stomach problems
  • High blood pressure
  • Any form of cardiovascular and circulatory disease
  • Liver or kidney disease
  • Any allergic reaction to certain medications
  • A low in salt diet
  • Pregnancy or breast-feeding
  • Tooth or gum disease
  • Sore throats or irritations

Are there any side effects?

Side effects can occur upon using the nicotine lozenges and may disappear quickly with continuous use. Some of the more common side effects include an irritation of the teeth, gums and throat, indigestion, diarrhoea or constipation, flatulence, insomnia, hiccups, headache, and coughing.

More serious side effects may also take place, although they are less frequent and a doctor should be consulted after stopping usage of the nicotine lozenges. More serious side effects include stomach pain and discomfort, dizziness or fainting, changes in hearing and vision, slight confusion, seizures or chest pains and palpitations.

What are the advantages of using this method?

  • They are handy and discreet.
  • The amount of nicotine that enters the body is controlled.
  • Nicotine is absorbed rapidly and therefore reduces cravings and withdrawal symptoms quicker.
  • They have proven to be a highly successful stop smoking tool.
  • They are simple and easy to use and control.
  • They are available in different doses.
  • They have a pleasant taste.
  • There are no special chewing techniques.
  • You do not have to carefully dispose of the lozenge.
  • They are sugar-free, which means that you won't put on weight.

Are there any disadvantages?

  • They look like sweets and should therefore be kept away from children.
  • They can cause sore throats and other side effects.
  • They may stick to dentures.
  • Can be costly.
  • You can become addicted to the lozenge.

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