How Does Nicotine Gum Work and Where Can You Get It?

Nicotine gum is a short-acting nicotine replacement product that you use when a craving hits. Health Canada describes nicotine replacement therapy as an over-the-counter medication, and HealthLinkBC says the gum comes in 2 mg and 4 mg strengths. This page is general information from public sources, so ask a pharmacist or doctor about your own use.

What is nicotine gum?

HealthLinkBC says the gum contains nicotine that is released slowly in your mouth and absorbed through the lining of the mouth. It looks and feels like regular chewing gum, and it comes in several flavours. It is one of the forms covered in our guide to nicotine replacement products in Canada, so this page goes deeper on gum only.

Where is it sold, and do you need a prescription?

Health Canada calls nicotine replacement therapy an over-the-counter medication. The page we read does not name the stores that carry it, and we could not open the Drug Product Database entry for gum (see the last section). HealthLinkBC’s gum page does not say whether a prescription is needed, so a pharmacist is the right person to ask where you live.

In British Columbia, the Smoking Cessation Program states that for gum, lozenges and patches “you do not need a prescription.” You and the pharmacist both sign a declaration form. Prescription quit drugs are a separate matter and are covered on our page about quit smoking medications.

What strengths and forms are there?

HealthLinkBC lists two strengths, 2 mg and 4 mg. It says to use the 4 mg strength if you smoke within 30 minutes of waking, or if your doctor recommends it. A second HealthLinkBC page says heavier smokers do better with a gum or lozenge of 4 mg.

The BC program’s list of eligible products shows gum in both strengths, in packs of 105, with one eligible flavour (Ultra Fresh Mint only). That is a rule for the BC program, and stores may sell other flavours.

How is nicotine gum used?

HealthLinkBC describes a method called chew and park. The steps it gives are:

1. Use one piece at a time.
2. Chew it slowly a few times until a peppery taste appears.
3. Park it between your cheek and gums.
4. Repeat for about 15 to 30 minutes, until the peppery taste stops.

The page explains why. Chewing steadily releases nicotine into saliva that you swallow, which can cause stomach ache, hiccups or heartburn, and the nicotine takes longer to reach your blood. It also says acidic drinks such as coffee, juice and soda can reduce absorption, and suggests avoiding them for 15 minutes before and after a piece.

HealthLinkBC states daily limits: no more than 30 pieces of the 2 mg gum or 20 pieces of the 4 mg gum in a day. It says most people use 10 to 15 pieces a day and that you cut back gradually, then stop at 1 or 2 pieces a day. We give no personal plan. Your pharmacist can work out a schedule with you, and our pharmacy programs page explains what many offer.

What are the side effects, and who should ask first?

HealthLinkBC says “all forms of NRT have side effects” and that most go away after the first week or so. Its gum page names the stomach effects of swallowing nicotine and sends readers to the package insert for a full list. If you are unsure whether withdrawal or the product is causing a symptom, see nicotine withdrawal symptoms.

Neither page lists groups who must see a doctor first. The general advice is to talk with your doctor about which product and dose might suit you. Health Canada adds that people who are pregnant or breastfeeding are steered toward short-acting forms over the patch. Read the package insert before you start, and call 8-1-1 in British Columbia to reach a pharmacist or physician.

How does gum compare with patches and lozenges?

HealthLinkBC says all NRT forms work equally well. The patch goes on once a day, while gum, lozenges, sprays and inhalers act quickly and can be used whenever you need extra nicotine. Gum can also replace the feel of a cigarette in your mouth.

Health Canada says short-acting forms can be used alone or with a patch, and that combining a long-acting and a short-acting form nearly triples the chance of quitting, against roughly doubling with one form. The lozenge is a close alternative, covered on our nicotine lozenge page. Our guide on choosing a quit method helps you weigh the options, and how long cravings last sets expectations.

Is nicotine gum free or covered?

Only British Columbia is confirmed here. The BC Smoking Cessation Program requires MSP enrolment and says PharmaCare covers the full cost of nicotine replacement. You can get one continuous course of up to 12 weeks (84 days) per calendar year, supplied one month at a time. The page says a course must start by November 6 to finish within the same calendar year. For other provinces, use free quit smoking help by province and what is free for me.

What we could not confirm

• The Health Canada Drug Product Database record for nicotine gum, including listed strengths and forms. We could not open it, so strengths above come from HealthLinkBC and the BC program.
• Which retailers sell nicotine gum, and whether any province besides BC treats it differently on prescription rules.
• A full official list of people who should ask a doctor or pharmacist before using gum. The pages we read do not give one.
• Gum-specific side effects beyond the stomach effects HealthLinkBC names.
• Coverage or free gum outside British Columbia. Alberta and Ontario pages could not be opened for this page.