The notion is that people using them should gradually be able to reduce their daily nicotine dose with minimal symptoms. Unfortunately, most smokers resume smoking over the ensuing weeks or months. Significant benefits of nicotine replacement are usually seen by the end of six weeks, but the effect diminishes over time. Evidence shows that the 2-mg size of nicotine gum available in the U.S. isn't adequate for heavy, dependent smokers. The nicotine patch delivers a continuous trickle of nicotine through the skin, producing a steady blood level.
Patients seem to have better compliance with patches than with nicotine gums.
Most people who use nicotine gum can withdraw from it easily within six months. The reason is that the delivery of nicotine is slow and gradual rather than the sharp spike of nicotine obtained from cigarettes. Weaning should occur gradually over a month or two. One can use a fixed tapering schedule or reduce the amount slowly according to symptoms. Nicotine is the substance in tobacco smoke that causes addiction to tobacco products.