Q. My uncle used nicotine gum to get off cigarettes. Now he chews the gum all the time. Do you think he’s hooked?

Over-the-counter nicotine gum, which is sold under a variety of brand names, was introduced in the United States in 1984. Since then, there have been many reports of gum addiction. There are chewers who’ve been consuming in excess of 10 pieces a day for more than a decade.

Nicotine is an insidious and highly-seductive drug that is responsible for making cigarettes an addiction. Nicotine gets into your brain, gives you pleasure and makes you want to come back for more. In addition, nicotine helps you to concentrate and reduces anxiety. There are many drug experts who rank nicotine over alcohol, cocaine or heroin for creating dependence.

Each year, about two million Americans use nicotine gum to quit smoking. The nicotine level in the gum is much lower than it is in cigarettes. You’re supposed to use the gum no longer than 12 weeks. More than half of those who use the gum stay with it for longer than six months.

The gum is available in 2-mg and 4-mg pieces. Users are instructed to use a piece of gum every 1-2 hours for the first 6 weeks, then to reduce use to one piece every 2-4 hours for 3 weeks, and one piece every 4-8 hours for 3 weeks. In highly dependent smokers, the 4-mg gum is superior to the 2-mg gum. Using nicotine gum can double the quitting success rate from about 10 to 20 percent. Most side effects such as a sore jaw or headache don’t last long. If you absorb too much nicotine accidentally, you may suffer some dizziness, a racing heart, nausea and insomnia.

If you try to stop chewing the gum and experience withdrawal symptoms, you’re probably addicted to the nicotine. Symptoms include headaches, irritability, depression and difficulty concentrating.

There’s no proof so far that chewing nicotine gum for long periods is harmful. While nicotine increases your heart rate and accelerates blood pressure, there is no known vascular or heart problems associated with long-term use of nicotine gum. One study has suggested that using the gum for a long time may lead to diabetes. Another study indicated that nicotine was linked to delays in the emptying of the stomach.

It’s not the nicotine in cigarettes that kills you. Cigarette smoke is a complex mixture of chemicals produced by the burning of tobacco and additives. The smoke contains tar, which is made up of more than 4,000 chemicals, including more than 60 known to cause cancer. Some of these substances cause heart and lung diseases, and all of them can be deadly.

One of the most cited problems with nicotine gum is the price. A daily supply of 10 pieces of the gum costs about the same as a pack of cigarettes.

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