Nicotine absorption and dependence in unlicensed lozenges available over the counter.

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.