# The more you know:Nicotine gum



## fbb1964 (12/5/21)

THE MORE YOU KNOW: Nicotine gum was created as "a tobacco substitute for oral use" with "suitable doses of nicotine" to "prevent the user from being exposed to the many harmful constituents of tobacco smoke," and one of the first flavors was chocolate/mocha. Sound familiar? Read on for an interesting and very relevant backstory of the invention of nicotine gum (as a smoking harm reduction product!)
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Ove Fernö, inventor nicotine gum, created it NOT as a nicotine "addiction" therapy, but as "a tobacco substitute for oral use" with "suitable doses of nicotine" which would "prevent the user from being exposed to the many harmful constituents of tobacco smoke."
His first idea was to use an aerosol containing nicotine, but "it tasted terrible" and "was too complicated."
The idea for gum came from submariners who couldn't smoke on their ship, so found smoke-free tobacco to be an effective substitute.
In 1969, after using the nicotine gum to quit smoking, he didn't stop chewing the nicotine gum until "after one year or so." So, the gum REPLACED smoking for him for a significant period.
When he made the first measurements in 1972 in people using gum, cigarettes and snuff, he "discovered that the absorption of nicotine was poor when compared with the absorption from cigarettes and snuff" and set out to improve absorption by increasing the pH of saliva.
He stated, "One of the first flavours was a mocha taste. The taste is important because nicotine has a very strong taste and it has to be masked in some way."
However, marketing the nicotine gum was problematic. Clinicians and scientists in the medical field, including several university professors, "warned that nicotine gum could be looked upon as unethical by the medical profession."
Tobacco control organizations "over emphasized the risk of nonsmokers, including children, becoming addicted to nicotine from the gum." However, "all this changed during the late 1970s, particularly after the publications from Michael Russell and his group."
Michael Russell, a psychiatrist and research scientist, was a pioneer in the study of tobacco dependence and the development of treatments to help smokers quit. He is often quoted as stating, "People smoke for nicotine, but they die from the tar."
Ironically, Ove's home country of Sweden--even with successful clinical trials--ruled that nicotine gum was neither a drug treatment nor a "foodstuff," an "impossible situation" that required his clinics to stop giving away the gum to help people quit smoking.
Researchers, clinics and advocates presented their case to the Tobacco Committee of the Ministry of Social Affairs, describing their experiences with the gum since 1970 with literally thousands of patients. This led to the gum being classified as a drug.
How did the gum come to be called "Nicorette"? Ove explained, "It means roughly, nicotine (Nico) delivered in the right (rette) way."
When asked if nasal nicotine spray would "continue addiction," because it more effectively delivered nicotine, he pointed out "Perhaps, but there are indications that NNS is particularly helpful for heavy smokers. If they did then have difficulty giving up NNS they could perhaps switch to the gum or the patch for a while. Don't forget that the pharmacokinetics of nicotine absorption are very different from smoking and chewing gum, much slower with the gum. I'm sure this is why it is very easy for most people on the gum to give it up."
In conclusion, he said "People in the [anti] smoking field have slowly but gradually accepted the idea. I think that in some sense the time was right. Psychological methods had been tried for years with only limited success so that the time was right for something new."
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It's important to note that, if not for the risks of harm from inhaling smoke, no one would have cared about nicotine "addiction" anymore than they care about caffeine "addiction." NRT was created as HARM REDUCTION. To quote Ove Fernö, maybe the time is again "right for something new."

Read full interview: https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1360-0443.1994.tb03300.x

Reactions: Informative 5


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