Questions posted in the The Addiction Forum have been answered by Steven Adelman, M.D. and by Richard C. Bozian M.D. F.A.C.P. of Harvard Vanguard Medical Group.

Question Title: nicorette gum

Forum: The Addiction Forum
Topic: Misc


I have been addicted to nicorette gum for 5 years. 6 to 12 pieces a day. I have developed severe cramps in the extremities. When I am on pedisone and other meds for copd the cramps increase. I now have a slight tremor a in the hands.Claw like cramps and severe weakness in the hands. Can my abuse of nicorette be a contributing factor?

Dear Peggy,

I assume that during the time that you've been using nicotine gum you haven't been smoking, and that prior to becoming dependent on nicotine gum you were dependent on tobacco. Your mention of COPD (chronic obstructive pulmonary disease) suggests that you had been a fairly heavy smoker for a pretty long time, since most people who smoke do not develop irreversible lung damage until they have smoked quite a bit.

If all my assumptions are correct, then you are to be congratulated for having given up cigarettes. It is certainly less harmful to your health for you to be absorbing pure nicotine via absorption from your mouth than it would be for you to have continued smoking tobacco and delivering nicotine to your lungs (and the rest of your body) along with tars, carcinogens, and carbon monoxide.

As nicotine may cause blood vessels to constrict, your concern that your symptoms of cramping and weakness in the extremities may be related to your use of nicotine gum is well-founded. You should consult with your primary care provider about your symptoms, and discuss with your PCP the possibility of getting expert consultation (with an Addiction Medicine specialist regarding your nicotine dependence, and with a peripheral vascular disease specialist regarding your extremity symptoms). As you proceed in attempting to resolve these problems, try not to get too down on yourself about your use of the gum. You'd be much worse off if you were still smoking, and many smokers do not get as far as you have gotten in giving up tobacco. Good luck.

Steve Adelman, M.D. (a.k.a. DrSteve)

This information is for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.

Keywords: nicotine gum, nicotine replacement, smoking cessation, claudication