Using Nicotine Lozenges to Quit Smoking

Guidelines for Using Lozenges as a Quit Aid

Side effects of Nicotine Lozenges

 Verywell / Gary Ferster 

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.

Many people use nicotine lozenges as an aid to quit smoking, though there are many things you should know and understand about these lozenges before using them.

At a Glance

Using a nictoine lozenge can help you deal with cravings and improve your chances of quitting smoking successfully. They have pros and cons, so it's important to decide if they are right for your needs. If you decide to try nicotine lozenges, be sure to follow the recommended dosing schedule, watch for side effects, and talk to your doctor if you have concerns or need additional assistance.

Pros and Cons of Nicotine Lozenges

Nicotine lozenges offer quick relief from cravings that are part of nicotine withdrawal. However, they are not a fail-safe solution.

Lozenges should be used on an as-needed basis, but in part, because 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 an 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 means you have to use them regularly and often and keep them readily available throughout the day, which can be a drawback.

According to the 2020 Surgeon General report on smoking cessation, an advantage to using a lozenge is that it may substitute for a cigarette because you put it in your mouth.

Nicotine Lozenge 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.

  • 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.

Nicotine Lozenge Dosing

You can choose the right lozenge strength based on when your first cigarette of the day typically was and following these guidelines:

  • If you have your first cigarette within 30 minutes of waking you should consider starting with the 4mg dose
  • If you have your first cigarette more than 30 minutes after waking you might consider starting with the 2mg strength

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

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, if you use any other NRT or smoke while using nicotine lozenges, you run the risk of a nicotine overdose.

Nicotine Lozenge Side Effects 

Side effects that are commonly associated with nicotine lozenge therapy include:

  • Heartburn
  • Hiccups
  • Indigestion
  • Nausea

Sore throatIf you experience any of the following 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, 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

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 medical conditions such as:

  • 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. Some nicotine replacement products contain aspartame which needs to be avoided in PKU.

Nicotine in excess 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.

Are Nicotine Lozenges Right for You?

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 emotional symptoms. Physical withdrawal symptoms can include, digestive issues, headaches, and feeling more hungry, while emotional symptoms can include a range of reactions including feeling irritable, anxious, sad, bored, and tired.

According to the American Cancer Society, NRT addresses some of the physical withdrawal symptoms.

However, it's important to seek other support for the emotional issues that can arise with nicotine cessation. 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.

Consider All Your Options

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.

Keep in Mind

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. 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.

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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.
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Additional Reading

By Terry Martin
Terry Martin quit smoking after 26 years and is now an advocate for those seeking freedom from nicotine addiction.