Nicotine Gum Dependence After Successful Smoking Cessation in a Patient with Chronic Obstructive Pulmonary Disease: A Case Report

Abstract

Background: Nicotine replacement therapy (NRT) is a first-line treatment for smoking cessation and is considered safe for patients with chronic obstructive pulmonary disease (COPD). However, prolonged dependence on nicotine gum is an uncommon but recognised complication. Case Presentation: We report the case of a 65-year-old woman with COPD who had a long history of tobacco smoking and was subsequently enrolled in a structured smoking cessation programme using nicotine gum. She achieved complete smoking abstinence but subsequently developed persistent dependence on nicotine gum, characterised by compulsive use, an inability to reduce consumption, and withdrawal symptoms upon discontinuation despite having stopped smoking cigarettes. Conclusion: Although nicotine gum is substantially less harmful than combustible tobacco, prolonged dependence can occur. Regular follow-up, gradual dose tapering, and behavioural counselling are essential components of smoking cessation programmes to prevent long-term NRT dependence.