Is Nicotine Gum Harmful to Your Health?

Many people turn to nicotine gum or patches to quit smoking. Called nicotine replacement therapy (NRT), they provide a low dose of the physically addictive substance in tobacco, without the smoke or toxins found in cigarettes and other tobacco products.

But many people wonder: Is nicotine harmful by itself? Laura Lucchesi, MS, BSN, a certified tobacco treatment specialist (CTTS) for the Tobacco Treatment and Counseling Program at University Hospitals, shares more.  

What Nicotine Does to the Body

Nicotine is a chemical compound found naturally in tobacco and certain plants. When smoked or ingested, nicotine enters the bloodstream and releases the “feel good” chemical dopamine in the brain. The effect is short-lived and most people feel the urge to have more of the addictive substance.

“Even though nicotine is not a cancer-causing substance, we know it’s not good for you,” says Lucchesi. Nicotine can cause and aggravate cardiovascular health issues, especially when taken steadily over long periods of time. It can increase blood pressure, heart rate and blood flow to the heart, while also contributing to the narrowing of arteries. In addition, nicotine is known to aggravate certain gastrointestinal issues and can delay the healing of surgical and other types of wounds.

“However, when you look at the benefits of quitting smoking with the aid of an NRT product versus continuing to smoke, nicotine is really quite benign.”

Side Effects of NRT

Lucchesi says that NRT products are highly safe and effective when used properly. Multiple studies have shown that using NRT nearly doubles a person’s chances of quitting tobacco.

For most people, side effects are mild and don’t last more than a week or two, if they occur at all, and may include:

• Nicotine patches: irritation or redness of the skin, dizziness, headache, nausea, racing heartbeat, muscle pain or stiffness, and sleep disturbances (including unusual and/or vivid dreams).
• Nicotine gum: mouth or throat irritation, bad aftertaste, nausea, hiccups, jaw pain, racing heartbeat, stomach upset and dizziness.
• Nicotine lozenges: cough, gas, heartburn, sleeping disturbances, nausea, hiccups, racing heartbeat and dizziness.
• Nicotine inhaler: cough, mouth or throat irritation, runny nose, nausea, headache, nervousness and racing heartbeat.
• Nicotine nasal spray: nose or throat irritation or burning, cough, watery eyes, sneezing, headache, nervousness and racing heartbeat.

Lucchesi says side effects are more common when people don’t use NRT products properly. For example, nicotine gum is not meant to be chewed like regular gum, which can cause stomach discomfort, acid reflux and other gastrointestinal issues. Rather, she advises patients to chew the gum a couple of times and tuck it between the inside of the cheek and the gums. This ensures the mucous membranes of the mouth absorb the nicotine directly into the bloodstream, not the stomach.

NRT Vs. Vaping

Some smokers try vaping with electronic cigarettes (e-cigarettes) to quit smoking. However, Lucchesi cautions that vaping is associated with its own risks to cardiovascular health. Because they aren’t regulated, vaping products tend to have variable and often very high levels of nicotine.

“With FDA-regulated NRT products, we know exactly what dose of nicotine people are getting, which is helpful when you’re weaning yourself off nicotine,” says Lucchesi. “The delivery of nicotine is also lower-dose and slower than vaping, so people are far less likely to get addicted to NRT.”

More Is Better Than Less

For most NRT products, the manufacturers recommend using them for 8 to 12 weeks. However, Lucchesi says it’s perfectly appropriate to use these products for longer periods of time.

“In our tobacco cessation clinic, we find that people have better outcomes when they use NRT for longer periods of time than the manufacturer recommends,” says Lucchesi. “These products are very safe for most people, so it’s generally okay to use them for as long as you need them. If anything, we see more relapses when people do not use their NRT product often enough or for a long enough period of time.”