My Doctor Online The Permanente Medical Group
Are you having back pain with any of the following?
- Severe pain, weakness or tingling in your leg(s).
- Difficulty stopping urination or loss of control of bladder or bowels.
- Unexplained fever, nausea or vomiting.
- A history of cancer or unexplained weight loss.
We understand that you are experiencing one or more of the health issues that might be impacting your back pain.
We recommend that you discuss these health issues with your doctor before proceeding with this program.
Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.
Using the Nicotine Lozenge to Quit Tobacco
The nicotine lozenge is a type of nicotine replacement therapy that is proven to increase your chances of successfully quitting tobacco. It contains nicotine (the addictive part of tobacco) without all the other dangerous chemicals in tobacco smoke. The lozenge can ease the cravings and other symptoms you might feel as your body withdraws from nicotine. This allows you to focus on your other strategies for living without tobacco.
How to use the lozenge
When used on its own, the lozenge should be used on a regular schedule, usually at least one lozenge every 1 to 2 hours. It's important to use the lozenge correctly:
- Don't eat or drink 15 minutes before use.
- Place one lozenge in your mouth.
- Let it dissolve slowly between your cheek and your gum.
- Do not chew or swallow the lozenge – your body absorbs the nicotine through your mouth, not though your stomach. If you swallow it, you won't get the right amount of nicotine.
Dosing
The lozenge is usually available in two strengths: 2 mg (which contains less nicotine) and 4 mg (which contains more nicotine).
- If you usually smoke your first cigarette within 30 minutes of waking up in the morning, we recommend you use the 4 mg strength.
- If you usually wait longer than 30 minutes after waking up in the morning to have your first cigarette, we recommend you use the 2 mg strength.
| Weeks after quitting | How often to use a lozenge |
| Weeks 1 through 6 | Use every 1 to 2 hours |
| Weeks 7, 8, and 9 | Use every 2 to 4 hours |
| Weeks 10, 11, and 12 | Use every 4 to 8 hours |
If you're using the nicotine lozenge in combination with the nicotine patch or bupropion we generally recommend that you use it as needed to help you with cravings. It can be helpful if you have "breakthrough" cravings while using other medications.
Possible side effects
Side effects of using the nicotine lozenge can include:
- Trouble sleeping
- Heartburn
- Headache
- Hiccups
- Coughing
- Nausea
If you're experiencing side effects severe enough to keep you from using this medication, let us know. There may be other forms of medication that you can use.
People who shouldn't use the lozenge
The nicotine lozenge might not be right for you if you're pregnant or are breastfeeding a baby, or if you have:
- Uncontrolled or worsening chest pain (angina)
- A very irregular or rapid heartbeat (severe arrhythmia)
- Had a heart attack in the past 2 weeks
- Uncontrolled high blood pressure
- Peripheral vascular disease (Reynaud's or Bruegger's syndrome)
Cost
The nicotine lozenge is available over the counter without a prescription. It costs approximately $65 for a one-week supply.
Related Health Tools:
Classes and Coaching
- Wellness Coaching Wellness Coaching
Interactive Programs
- Quit Tobacco Medications Quit Tobacco Medications
- Quit smoking with Breathe™ Quit smoking with Breathe™
Podcasts
- Quitting Smoking Quitting Smoking
- Second-Hand Smoke Second-Hand Smoke
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.