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Nicotine absorption and dependence in unlicensed lozenges available over the counter
J Foulds1, M A Russell, M J Jarvis
1Department of Psychology, University of Surrey, London, UK. j.foulds@surrey.ac.uk
Aim:
To demonstrate the nicotine absorption and dependence potential from unlicensed nicotine containing lozenges.
Design:
A single case report of dependence on nicotine lozenges, plus measurements of nicotine levels before and after consumption of eight nicotine lozenges over 2 hours in volunteers.
Setting:
Hospital Smokers' Clinic.
Participants:
One male patient suffering from schizophrenia who had consumed 150 "Stoppers" lozenges per day for the previous 5 years, plus seven non-smoker volunteers.
Measurements:
Blood nicotine concentration.
Findings:
The patient's low expired carbon monoxide level (5 p.p.m.) and high plasma nicotine (32 ng/ml) and cotinine levels (947 ng/ml) were consistent with very heavy lozenge consumption. The non-smoker volunteers obtained nicotine concentrations of around 11 ng/ml by consuming eight Stoppers lozenges over 2 hours. Other brands of nicotine lozenges produced lower initial levels, but also produced delayed intestinal absorption and vomiting after food consumption.
Conclusion:
Nicotine lozenges are a potential aid to smoking cessation but their safety, efficacy and abuse potential remain to be properly evaluated.