It’s Not Cool to Go Cold Turkey When Quitting Nicotine Chewing Gum: A Case Report

Past smokers under nicotine replacement therapy, such as nicotine gums, may develop an addiction to nicotine gums. This case report presents a case of nicotine gum addiction. The mother of a 28-year-old male presented at a private dental & tobacco cessation clinic with her son's complaints of severe cravings after her son had reportedly gone cold turkey as an impulsive attempt to quit nicotine chewing gums. She reported that her son had a history of chewing >10 nicotine gums/day for the last three years. The mother reported that her son had been without nicotine for the last two days before he had agreed to seek professional help. She presented that her son had repeatedly failed to stop using nicotine gum use in the past. Detailed tobacco and nicotine gum history was recorded. Current nicotine dependence was assessed using a modified Fagerstrom scale for smokeless tobacco. The patient's withdrawal symptoms were more of a psychological nature than disturbances of physiology. As per the patient's preference, tele-counseling sessions were conducted daily. Additionally, supportive and interventional measures were recommended and reinforced through WhatsApp messages. As there were rebounds of anxiety attacks, in consultation with a psychiatrist, after a week of counseling, pharmacological management was included as an adjunct to help improve the patient's confidence. The patient had abstained from nicotine gums for one complete month from the date of reporting, with only negligible withdrawal symptoms. A one-month follow-up of the patient confirmed no signs of relapse. The report brings to light that dealing with going cold turkey in long-term nicotine gum addiction can be challenging and recommends a planned professional cessation therapy in order to minimize withdrawal symptoms.