Forms of cocaine and psychiatric symptoms.

he reduced daily usage of nicotine gum to 16, 12, and 5 pieces, respectively, while using 3, 7, and 14 pieces of placebo gum. During week 6, he used no nicotine gum intake and averaged 17 pieces of placebo gum per day. During week 7 the 19 pieces of gum he used were divided between placebo gum and bubble gum. By week 8 and at the six-month follow-up he was using only bubble gum. We confirmed that he was not smoking (CO levels were negligible) and that nicotine gum use had been eliminated as planned (cotinine levels were 375, 66, and 0 [ < 20] ng/ml at weeks 2, 6, and 32, respectively). In this case a simple procedure enabled a patient to achieve abstinence from nicotine gum without adverse effects such as resuming cigarette smoking or nicotine withdrawal symptoms. Whereas occasional use of nicotine gum may be required long-term to prevent relapse to tobacco use in some people abstinence from any source of nicotine is the target recommended by the manufacturers of nicorette and that is what gum users and those treating them aim for.1,2 Our experience suggests that it might be useful for a placebo (nicotine) gum to be made commercially available.