Physical dependence on nicotine in gum. A placebo substitution trial

JAMA. 1986 Jun 20;255(23):3277-9.


To test whether ex-smokers become physically dependent on nicotine in gum, we entered eight ex-smokers who were using nicotine gum into a randomized, double-blind, placebo-substitution trial. When placebo was substituted, seven of the eight subjects were observed to have withdrawal symptoms and two relapsed to smoking or nicotine gum. This result suggests that physical dependence (ie, withdrawal) may be a cause of behavioral dependence on nicotine gum (ie, use of gum beyond the recommended period) and physicians should emphasize the need for gradual reduction of nicotine gum.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Chewing Gum
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nicotine* / administration & dosage
  • Placebos
  • Random Allocation
  • Substance Withdrawal Syndrome / etiology*
  • Substance-Related Disorders / complications
  • Substance-Related Disorders / etiology*
  • Tobacco Use Disorder / rehabilitation


  • Chewing Gum
  • Placebos
  • Nicotine