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Claes Lundgren and Stephan Lichtnecker

Chewing gum and smoking – the background to Nicorette

”How did you get the idea for Nicorette?” – Professor Claes Lundgren (now in the United States) responds that he had long pondered the idea of an addictive dependency on nicotine when US researcher Dr. Edward Lanphier visited him in 1968. Dr. Lanphier planned to study the research at the Aviation and Naval Medicine division of the Department of Physiology. At the time, Dr. Lanphier had a rather severe respiratory infection, but despite the phlegm and the cough, he continued to chain smoke as usual, lighting one cigarette from the butt of the last one.

Professor Lundgren suggested that Dr. Lanphier try the cure for smoking often used in submarines - chewing tobacco or snuff. At the tobacconist's shop on Bangatan they bought a couple of packets of the strongest chewing tobacco available, consisting of small dark brown sticky bits of tobacco. Dr. Lanphier immediately tucked several pieces under his lip and that was the end of his smoking. After that he affectionately called the little pieces of tobacco ”the mouse droppings that saved my life.”

Dr. Lundgren and colleague Stephan Lichtneckert occasionally tested oxygen breathing in a pressure chamber on naval personnel. Smoking was strictly forbidden at such times because of the risk of fire, but the subjects used snuff to satisfy their need for tobacco. Drs. Lundgren and Lichtneckert worked with Ove Fernö, research supervisor at pharmaceutical company Leo in Helsingborg, to develop an alternative to snuff - nicotine chewing gum. They were convinced that the desire to smoke was often a pure nicotine dependence that could be considered a form of addiction.

 

Meanwhile, for several years the Department of Clinical Physiology at University Hospital had been trying to get smokers to quit their bad habit. These patients had vascular or pulmonary diseases and needed help – a suitable clientele on which to try out the nicotine chewing gum. In a double-blind experiment the researchers showed that chewing gum with nicotine was more effective than chewing gum with placebo (they were given gum that had a nicotine-like pepper flavor). The ”medical council” at Leo was at first extremely skeptical about the new discovery, but eventually became convinced that nicotine substitution could be a valuable smoking cessation method.

The former smokers were indeed converted to ”chewers” and it usually was not a problem for them to stop using the gum later on. The amount of nicotine in the chewing gum was about the same as in smoking and snuff, but apparently caused less damage, since the chewer is not exposed to either tar or other harmful products in smoke, such as formalin.

The nicotine chewing gum was called Nicorette and became a huge success. It also involved a new treatment principle and was followed by drugs with nicotine using other delivery mechanisms, such as patches and spray. The pharmaceutical company Leo was eventually acquired by Pfizer and Nicorette is still one this corporate giant’s bestsellers.

Text: Håkan Westling