If patient smokes less than 25 cigarettes/day, start with 2 mg; if more than 25 cigarettes/day, start with 4 mg. Have patient chew one piece of gum whenever the urge to smoke occurs. Have the patient chew each piece slowly until it tingles, then place it between the cheek and gums; when tingle is gone, have patient chew gum again and repeat the process. Gum usually lasts for about 30 min to promote even, slow, buccal absorption of nicotine. Patients often require 10 pieces daily during the
first month. Do not exceed 24 pieces daily. Therapy may be effective for up to 3 mo; 4–6 mo for complete cessation has been used. Should not be used for longer than 4 mo.

Start with 2 mg if patient first smokes more than 30 min after waking up; 4 mg if patient starts smoking within 30 min of waking. Patient must place lozenge in mouth, let dissolve over 20–30 min, and avoid eating or drinking anything other than water for 15 min before use. In week 1–6, use 1 lozenge every 1–2 hr; in week 7–9, use 1 lozenge every 2–4 hr; in week 10–12, use 1 lozenge every 4–8 hr. Do not exceed 5 lozenges in 6 hr or 20 daily.