Maryland's Tobacco Resource Center - Linking Professionals to Best Practices

Nicotine Lozenges

How it works: 1

  • The over-the-counter lozenge (Commit lozenge) is available in 2 strengths: 2 mg and 4 mg. The 2 mg is recommended for ‘low-dependence’ smokers (do not smoke within 30 minutes of waking up), and the 4 mg is recommended for ‘high-dependence’ smokers (smoke within 30 minutes of waking up)
  • Nicotine lozenges should be dissolved in the mouth rather than chewed and swallowed.

What the evidence says:

  • Strength of Evidence: B The Clinical Practice Guide states that the nicotine lozenge  is, “appropriate as a first-line medication for treating tobacco use” with precautions for pregnant women and individuals with cardiovascular disease (DHHS, 2008, p. 49).
  • Quitting rates
    • Research has found that nicotine lozenges significantly increased quit rates relative to placebo at six weeks and one year among light smokers (<15 cigarettes/day).2
    • Nicotine lozenges have demonstrated effectiveness for those who have a history of past failure with pharmacologic treatment.4
  • Coping with Cravings
    • A recent report demonstrated a nicotine lozenge to be superior to placebo in reducing smoking urge, as well as significantly improved vigilance and psychomotor performances.3

Possible Side Effects:

  • Trouble sleeping
  • Nausea
  • Hiccups
  • Coughing
  • Heartburn
  • Headache
  • Flatulence (gas)

Where to get it:

  • Lozenges can be obtained over-the-counter at most pharmacies.
  • Commercial brands include:
    • Commit Lozenge:
      • Convenient packaging for discrete use
      • Available in mint flavor
    • Nicorette Lozenge:
      • Available in at least 3 flavors
      • Also available in “mini” lozenges
References: 

1. Fiore, M. C., Jaen, C. R., Baker, T. B., & al., e. (2008). Treating Tobacco Use and Dependence 2008 Update.  Clinical Practice Guideline. In U.S. Department of Health and Human Services (Ed.). Rockville, MD: U.S. Department of Health and Human Services. http://www.ahrq.gov/path/tobacco.htm

2. Shiffman, S. (2005). Nicotine lozenge efficacy in light smokers. Drug and Alcohol Dependence, 77, 311-14.

3. Demazieres, A., et al. (2006). Ability of a new oral nicotine substitute to reduce smoking urge in moderate smokers. Addictive Behaviors, 31, 537-543.

4. Shiffman, S., et al. (2005). Nicotine patch and lozenge are effective for women. Nicotine and Tobacco Research, 71, 119-127.