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    Nicotine Gum OK for Gradual Quitters

    Study Shows Nicotine-Replacement Gum Works Even If You Don't Quit Smoking Cold Turkey

    Smokers Who Quit Gradually continued...

    The 4-milligram dosage is generally recommended for heavy smokers -- those who typically smoke 25 or more cigarettes a day.

    Participants were instructed to cut down on cigarettes while increasing their use of the gum over a two-month period, but they were not given explicit instructions on how to do this, Shiffman says. Participants reviewed FDA-approved labeling for the gum products.

    Those who reported giving up cigarettes at the end of two months were followed for an additional four months, during which time they were allowed, but not required, to continue using the nicotine-replacement gum or a placebo.

    During the first four weeks of the study, the researchers evaluated the impact of simultaneous use of cigarettes and nicotine-replacement gum.

    They found no difference in adverse outcomes among the heaviest nicotine users (who averaged 22 cigarettes a day and nine pieces of 4-milligram gum) compared to people who used less nicotine.

    At the end of six months, smokers on active nicotine-replacement therapy were more likely to have stopped smoking than those who chewed the placebo gum.

    Shiffman acknowledges that the success rate for all the study participants was low. But the 6% quit rate for the smokers who chewed the 4-milligram nicotine-replacement gum was roughly double that typically reported in studies evaluating smokers who try to quit without help.

    Nicotine Gum 'Better Than Smoking'

    The study did not examine nicotine gum use for longer than six months, but it is clear that many people stay on the gum or other forms of nicotine-replacement therapy for much longer.

    New York University professor of medicine and smoking-cessation researcher Scott Sherman, MD, tells WebMD that the evidence suggests that long-term use of nicotine-replacement treatments is safe and "a whole lot better for you than smoking."

    While nicotine is the agent that gets people hooked on cigarettes, other chemical toxins in cigarette smoke are the cause of lung cancer and other health effects.

    But while long-term use of nicotine-replacement products appears safe, Sherman says there is less evidence that it is effective.

    "It is not really clear if using nicotine gum or patches or even other forms of medication for a year instead of three months improves your chances of quitting smoking," he says. "We can't really tell people that they will be more likely to be a nonsmoker 10 years down the road if they chew nicotine gum for an extra year."

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