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September 26, 1990, Vol 264, No. 12 >
ARTICLE | September 26, 1990

Drinking Coffee and Carbonated Beverages Blocks Absorption of Nicotine From Nicotine Polacrilex Gum FREE

Jack E. Henningfield, PhD; Aleksandras Radzius; Thomas M. Cooper, DDS; Richard R. Clayton, PhD
[+] Author Affiliations

Reprint requests to NIDA Addiction Research Center, PO Box 5180, Baltimore, MD 21224 (Dr Henningfield).


JAMA. 1990;264(12):1560-1564. doi:10.1001/jama.1990.03450120072032
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References

Patients failing to obtain benefit from nicotine polacrilex gum in their efforts to quit smoking may be inadvertently blocking nicotine absorption. Effective nicotine absorption depends on the mildly alkaline saliva that is produced when buffering agents in the polacrilex are released along with nicotine as the polacrilex is chewed. We found that intermittent mouth rinsing with coffee or cola, but not distilled water, substantially reduced salivary pH and nicotine absorption. Because many commonly consumed substances were also found to be highly acidic, we recommend that patients do not ingest any substance during or immediately before nicotine polacrilex use.

(JAMA. 1990;264:1560-1564)

REFERENCES

1 +
The Health Consequences of Smoking: Nicotine Addiction . Report of the Surgeon General. Washington, DC: US Dept of Health and Human Services; 1988;. Publication (CDC) 88-8406.
2 +
Snyder FR, Henningfield JE.  Effects on nicotine administration following 12 h of tobacco deprivation: assessment on computerized performance tasks . Psychopharmacology. 1989;;97:17-22.
3 +
Nemeth-Coslett R, Henningfield JE, O'Keeffe MK, Griffiths RR.  Nicotine gum: dose-related effects on cigarette smoking and subjective ratings . Psychopharmacology . 1987;;92:424-430.
4 +
Stitzer ML, Gross J.  Smoking relapse: the role of pharmacological and behavioral factors . In: Pomerleau OF, Pomerleau CS, Fagerström KO, Henningfield JE, Hughes JR, eds. Nicotine Replacement: A Critical Evaluation . New York, NY: Alan R Liss Inc; 1988;:163-184.
5 +
Fagerström KO.  Reducing the weight gain after stopping smoking . Addict Behav. In press.
6 +
Killen JD, Maccoby N, Taylor CB.  Nicotine gum and self-regulation training in smoking relapse prevention . Behav Ther. 1984;;15:234-248.
7 +
Hall SM, Tunstall C, Ginsberg D, Benowitz NL, Jones RT.  Nicotine gum and behavioral treatment: a placebo controlled trial . J Consult Clin Psychol. 1987;;55:603-605.
8 +
Henningfield JE, Woodson PP.  Dose-related action of nicotine on behavior and physiology: review and implications for replacement therapy for nicotine dependence . J Subst Abuse. 1989;;1:301-317.
9 +
Cummings SR, Hansen B, Richard RJ, Stein MJ, Coates TJ.  Internists and nicotine gum . JAMA . 1988;;260:1565-1569.
10 +
Jarvik ME, Henningfield JE.  Pharmacologic treatment of tobacco dependence . Pharmacol Biochem Behav. 1988;;30:279-294.
11 +
Axelsson A, Brantmark B.  The anti-smoking effect of chewing gum with nicotine of high and low bioavailability . In: Steinfeld J, Griffiths W, Ball K, Taylor RM, eds. Smoking and Health: Proceedings of the Third World Conference on Smoking and Health . Washington, DC: US Dept of Health, Education, and Welfare; 1977;:549-559. Publication (NIH) 77-1413.
12 +
Ferno O.  The development of chewing gum containing nicotine and some comments on the role played by nicotine in the smoking habit . In: Steinfeld J, Griffiths W, Ball K, Taylor RM, eds. Smoking and Health: Proceedings of the Third World Conference on Smoking and Health . Washington, DC: US Dept of Health, Education, and Welfare; 1977;:569-573. Publication (NIH) 77-1413.
13 +
Benowitz NL, Jacob P, Savanapridi C.  Determinants of nicotine intake while chewing nicotine polacrilex gum . Clin Pharmacol Ther. 1987;;41: 467-473.
14 +
Benowitz NL, Porchet H, Sheiner L, Jacob P.  Nicotine absorption and cardiovascular effects with smokeless tobacco use: comparison with cigarette and nicotine gum . Clin Pharmacol Ther. 1988;;44: 23-28.
15 +
Russell MAH, Feyerabend C, Cole PV.  Plasma nicotine levels after cigarette smoking and chewing nicotine gum . BMJ . 1976;;1:1043-1046.
16 +
Pickworth WB, Herning RI, Henningfield JE.  Mecamylamine reduces some EEG effects of nicotine chewing gum in humans . Pharmacol Biochem Behav. 1988;;30:149-153.
17 +
Nemeth-Coslett R, Benowitz NL, Robinson N, Henningfield JE.  Nicotine gum: chew rate, subjective effects and plasma nicotine . Pharmacol Biochem Behav. 1988;;29:747-751.
18 +
Fischman MW, Mello NK, eds. Testing for Abuse Liability of Drugs in Humans . Bethesda, Md: National Institute on Drug Abuse; 1989;. Research monograph 92.
19 +
Hariharan M, VanNoord T, Greden JF.  A high-performance liquid-chromatographic method for routine simultaneous determination of nicotine and cotinine in plasma . Clin Chem. 1988;;34:724-729.
20 +
O'Mahony M.  The interstimulus interval for taste, 1: the efficiency of expectoration and mouthrinsing in clearing the mouth of salt residuals . Perception. 1972;;1:209-215.
21 +
Henningfield JE, Radzius A, Cooper TM, Clayton RR.  Oral pH: a factor in the treatment of nicotine addiction . J Am Dental Assoc . In press.
22 +
Brantmark B, Ohlin P, Westling H.  Nicotine-containing chewing gum as an anti-smoking aid . Psychopharmacologia . 1973;;31:191-200.
23 +
Ferno O.  A substitute for tobacco smoking . Psychopharmacologia. 1973;;31:201-204.
24 +
Schneider N. How to Use Nicotine Gum . New York, NY: Pocket Books; 1988;.
25 +
Cooper TM, Clayton RR.  Stop-smoking program using nicotine reduction therapy and behavior modification for heavy smokers . J Am Dent Assoc. 1989;;118:47-52.
26 +
Lagerlof F, Dawes C.  The volume of saliva in the mouth before and after swallowing . J Dent Res. 1984;;63:618-621.
27 +
Norris MB, Noble AC, Pangborn RM.  Human saliva and taste responses to acids varying in anions titratable acidity, and pH . Physiol Behav. 1984;;32:237-244.
28 +
Parvinen T, Larmas M.  The relation of stimulated salivary flow rate and pH to lactobacillus and yeast concentrations in saliva . Dent Res. 1981;;60: 1929-1935.
29 +
Christensen CM, Brand JG, Malamud D.  Salivary changes in solution pH: a source of individual differences in sour taste perception . Physiol Behav. 1987;;40:221-227.
30 +
Christensen CM.  Importance of saliva in diettaste relationship . In: Kare MR, Brand JG, eds. Interaction of the Chemical Senses with Nutrition . Orlando, Fla: Academic Press Inc; 1986;:3-24.
31 +
Christensen CM, Navazesh M.  Anticipatory salivary flow to the sight of different foods . Appetite. 1984;;5:307-315.
32 +
Christensen CM, Brand JC, Malamud DM.  Salivary changes in solution pH: a source of individual differences in sour taste perception . Pharmacol Biochem Behav. 1987;;40:221-227.
33 +
Sachs DPL.  Nicotine polacrilex: practical use requirements . Curr Pulmonol. 1989;;10:141-158.
34 +
Cooper TM, Clayton RR. The Cooper/Clayton Method to Stop Smoking . Lexington, Ky: SBC/ SBC Inc; 1988;.
35 +
Gilbert RM.  Coffee, tea and cigarette use . Can Med Assoc J. 1979;;120:522-524.
36 +
Fagerström KO, Schneider NG.  Measuring nicotine dependence in tobacco smoking: a review of the Fagerström tolerance questionnaire . J Behav Med. 1989;;12:159-182.
37 +
The Health Consequences of Using Smokeless Tobacco . Report of the Advisory Committee to the Surgeon General. Washington, DC: US Dept of Health and Human Services; 1986;. National Institutes of Health publication 86-2874.
38 +
Henningfield JE, Nemeth-Coslett R.  Nicotine dependence: interface between tobacco and tobacco-related disease . Chest. 1988;;93:37S-55S.
39 +
Reducing the Health Consequences of Smoking: 25 Years of Progress . Report of the Surgeon General. Washington, DC: US Dept of Health and Human Services; 1989;. Publication (CDC) 89-8411.
40 +
Schwartz JL. Review and Evaluation of Smoking Cessation Methods: United States and Canada, 1978-1985 . Washington, DC: US Dept of Health and Human Services; 1987;. National Institutes of Health publication 87-2940.
41 +
Fortmann SP, Killen JD, Telch MJ, Newman B.  Minimal contact treatment for smoking cessation . JAMA . 1988;;260:1575-1580.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

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1 +
The Health Consequences of Smoking: Nicotine Addiction . Report of the Surgeon General. Washington, DC: US Dept of Health and Human Services; 1988;. Publication (CDC) 88-8406.
2 +
Snyder FR, Henningfield JE.  Effects on nicotine administration following 12 h of tobacco deprivation: assessment on computerized performance tasks . Psychopharmacology. 1989;;97:17-22.
3 +
Nemeth-Coslett R, Henningfield JE, O'Keeffe MK, Griffiths RR.  Nicotine gum: dose-related effects on cigarette smoking and subjective ratings . Psychopharmacology . 1987;;92:424-430.
4 +
Stitzer ML, Gross J.  Smoking relapse: the role of pharmacological and behavioral factors . In: Pomerleau OF, Pomerleau CS, Fagerström KO, Henningfield JE, Hughes JR, eds. Nicotine Replacement: A Critical Evaluation . New York, NY: Alan R Liss Inc; 1988;:163-184.
5 +
Fagerström KO.  Reducing the weight gain after stopping smoking . Addict Behav. In press.
6 +
Killen JD, Maccoby N, Taylor CB.  Nicotine gum and self-regulation training in smoking relapse prevention . Behav Ther. 1984;;15:234-248.
7 +
Hall SM, Tunstall C, Ginsberg D, Benowitz NL, Jones RT.  Nicotine gum and behavioral treatment: a placebo controlled trial . J Consult Clin Psychol. 1987;;55:603-605.
8 +
Henningfield JE, Woodson PP.  Dose-related action of nicotine on behavior and physiology: review and implications for replacement therapy for nicotine dependence . J Subst Abuse. 1989;;1:301-317.
9 +
Cummings SR, Hansen B, Richard RJ, Stein MJ, Coates TJ.  Internists and nicotine gum . JAMA . 1988;;260:1565-1569.
10 +
Jarvik ME, Henningfield JE.  Pharmacologic treatment of tobacco dependence . Pharmacol Biochem Behav. 1988;;30:279-294.
11 +
Axelsson A, Brantmark B.  The anti-smoking effect of chewing gum with nicotine of high and low bioavailability . In: Steinfeld J, Griffiths W, Ball K, Taylor RM, eds. Smoking and Health: Proceedings of the Third World Conference on Smoking and Health . Washington, DC: US Dept of Health, Education, and Welfare; 1977;:549-559. Publication (NIH) 77-1413.
12 +
Ferno O.  The development of chewing gum containing nicotine and some comments on the role played by nicotine in the smoking habit . In: Steinfeld J, Griffiths W, Ball K, Taylor RM, eds. Smoking and Health: Proceedings of the Third World Conference on Smoking and Health . Washington, DC: US Dept of Health, Education, and Welfare; 1977;:569-573. Publication (NIH) 77-1413.
13 +
Benowitz NL, Jacob P, Savanapridi C.  Determinants of nicotine intake while chewing nicotine polacrilex gum . Clin Pharmacol Ther. 1987;;41: 467-473.
14 +
Benowitz NL, Porchet H, Sheiner L, Jacob P.  Nicotine absorption and cardiovascular effects with smokeless tobacco use: comparison with cigarette and nicotine gum . Clin Pharmacol Ther. 1988;;44: 23-28.
15 +
Russell MAH, Feyerabend C, Cole PV.  Plasma nicotine levels after cigarette smoking and chewing nicotine gum . BMJ . 1976;;1:1043-1046.
16 +
Pickworth WB, Herning RI, Henningfield JE.  Mecamylamine reduces some EEG effects of nicotine chewing gum in humans . Pharmacol Biochem Behav. 1988;;30:149-153.
17 +
Nemeth-Coslett R, Benowitz NL, Robinson N, Henningfield JE.  Nicotine gum: chew rate, subjective effects and plasma nicotine . Pharmacol Biochem Behav. 1988;;29:747-751.
18 +
Fischman MW, Mello NK, eds. Testing for Abuse Liability of Drugs in Humans . Bethesda, Md: National Institute on Drug Abuse; 1989;. Research monograph 92.
19 +
Hariharan M, VanNoord T, Greden JF.  A high-performance liquid-chromatographic method for routine simultaneous determination of nicotine and cotinine in plasma . Clin Chem. 1988;;34:724-729.
20 +
O'Mahony M.  The interstimulus interval for taste, 1: the efficiency of expectoration and mouthrinsing in clearing the mouth of salt residuals . Perception. 1972;;1:209-215.
21 +
Henningfield JE, Radzius A, Cooper TM, Clayton RR.  Oral pH: a factor in the treatment of nicotine addiction . J Am Dental Assoc . In press.
22 +
Brantmark B, Ohlin P, Westling H.  Nicotine-containing chewing gum as an anti-smoking aid . Psychopharmacologia . 1973;;31:191-200.
23 +
Ferno O.  A substitute for tobacco smoking . Psychopharmacologia. 1973;;31:201-204.
24 +
Schneider N. How to Use Nicotine Gum . New York, NY: Pocket Books; 1988;.
25 +
Cooper TM, Clayton RR.  Stop-smoking program using nicotine reduction therapy and behavior modification for heavy smokers . J Am Dent Assoc. 1989;;118:47-52.
26 +
Lagerlof F, Dawes C.  The volume of saliva in the mouth before and after swallowing . J Dent Res. 1984;;63:618-621.
27 +
Norris MB, Noble AC, Pangborn RM.  Human saliva and taste responses to acids varying in anions titratable acidity, and pH . Physiol Behav. 1984;;32:237-244.
28 +
Parvinen T, Larmas M.  The relation of stimulated salivary flow rate and pH to lactobacillus and yeast concentrations in saliva . Dent Res. 1981;;60: 1929-1935.
29 +
Christensen CM, Brand JG, Malamud D.  Salivary changes in solution pH: a source of individual differences in sour taste perception . Physiol Behav. 1987;;40:221-227.
30 +
Christensen CM.  Importance of saliva in diettaste relationship . In: Kare MR, Brand JG, eds. Interaction of the Chemical Senses with Nutrition . Orlando, Fla: Academic Press Inc; 1986;:3-24.
31 +
Christensen CM, Navazesh M.  Anticipatory salivary flow to the sight of different foods . Appetite. 1984;;5:307-315.
32 +
Christensen CM, Brand JC, Malamud DM.  Salivary changes in solution pH: a source of individual differences in sour taste perception . Pharmacol Biochem Behav. 1987;;40:221-227.
33 +
Sachs DPL.  Nicotine polacrilex: practical use requirements . Curr Pulmonol. 1989;;10:141-158.
34 +
Cooper TM, Clayton RR. The Cooper/Clayton Method to Stop Smoking . Lexington, Ky: SBC/ SBC Inc; 1988;.
35 +
Gilbert RM.  Coffee, tea and cigarette use . Can Med Assoc J. 1979;;120:522-524.
36 +
Fagerström KO, Schneider NG.  Measuring nicotine dependence in tobacco smoking: a review of the Fagerström tolerance questionnaire . J Behav Med. 1989;;12:159-182.
37 +
The Health Consequences of Using Smokeless Tobacco . Report of the Advisory Committee to the Surgeon General. Washington, DC: US Dept of Health and Human Services; 1986;. National Institutes of Health publication 86-2874.
38 +
Henningfield JE, Nemeth-Coslett R.  Nicotine dependence: interface between tobacco and tobacco-related disease . Chest. 1988;;93:37S-55S.
39 +
Reducing the Health Consequences of Smoking: 25 Years of Progress . Report of the Surgeon General. Washington, DC: US Dept of Health and Human Services; 1989;. Publication (CDC) 89-8411.
40 +
Schwartz JL. Review and Evaluation of Smoking Cessation Methods: United States and Canada, 1978-1985 . Washington, DC: US Dept of Health and Human Services; 1987;. National Institutes of Health publication 87-2940.
41 +
Fortmann SP, Killen JD, Telch MJ, Newman B.  Minimal contact treatment for smoking cessation . JAMA . 1988;;260:1575-1580.

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