Acute effects of nicotine gum on blood pressure and pulse rate
Noor Zurani Md Haris Robson, Consultant and Addiction Specialist, Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur

Abstract
Objective: To assess the effect of chewing a piece of 2 mg nicotine gum on systolic blood pressure (SBP), diastolic blood pressure (DBP) and pulse rate (PR).

Methodology: Blood pressure and pulse rate were measured on 176 abstinent smokers, at two time points; before (at 0 min) and after nicotine gum administration (at 120 min).

Results: The baseline SBP was 106.3 ±13.6 mmHg (range 75.0 – 140.0) and baseline DBP was 69.6 ±9.4 mmHg (range 50.0 – 100.0). Three subjects (two female ex-smokers aged 62 years and one male current smoker aged 28 years) had high DBP above 90 mmHg. The baseline PR was 70.0 ± 9.0 beats/min (range 46.0–99.0). At two hours after chewing nicotine gum, there was no change in SBP (106.3± 13.1 mmHg at 120 min (t 174 = 0.11, p=0.9)) but there was a significant increase in DBP (71.7± 9.9 mmHg at 120 min (t 174 = -2.9, p=0.004)), and a significant reduction in PR (68.4 ± 10.4 beats/min at 120 min (t 175 =2.13, p<0.001)).

Conclusion: The variable effect of nicotine gum at different time points have important implications on the usefulness of nicotine gum as nicotine replacement therapy, in particular on individuals with hypertension or cardiac diseases.