Guidelines for Nicotine Replacement Therapy: Lozenges

These instructions are for Children’s Hospital of Philadelphia patients who are beginning nicotine replacement therapy.

Patient instructions: nicotine lozenges

Congratulations on taking the next step to become tobacco free!

• Place lozenge in mouth and allow it to dissolve slowly. The nicotine release may cause a warm, tingling feeling.

• Do not chew or swallow lozenge.

• Move lozenge around to different areas of the mouth.

• Standard lozenges will dissolve completely in about 20-30 minutes; nicotine mini lozenges  will dissolve in 10 minutes.

Recommended use:

If you smoke less than 20 cigarettes a day or vape less than 15 times a day. (One "time" consists of around 15 puffs or lasts around 10 minutes)

• Use 2mg nicotine lozenges.

If you smoke more than 20 cigarettes a day or vape more than 15 times day (One "time" consists of around 15 puffs or lasts around 10 minutes)

• Use 4mg nicotine lozenges.

Throughout nicotine replacement therapy, try to increase the amount of time between each lozenge. You may use up to 20 lozenges each day. Do not use more than 20 pieces in one day.

• Weeks 1-6: Use 1 lozenge every 1 to 2 hours as needed.

• Weeks 7-9: Use 1 lozenge every 2 to 4 hours as needed.

• Weeks 10-12: Use 1 lozenge every 4 to 8 hours as needed.

Temporary side effects of lozenges include:

• Hiccups

• Coughing

• Soreness of teeth and gums

• Heartburn

• Headaches

• Hard time sleeping

• Upset stomach or gas

Reviewed on November 2023, by Leighann Sweeney, RRT-NPS, CTTS, AE-C