Bob Berens, a television writer in Los Angeles, first noticed back in July that it was getting hard to find the Nicorette lozenges he’d been consuming religiously ever since he quit smoking seven years ago. Neighborhood stores were tapped out. Soon, he was driving across the city to locate even a single box of the elusive product. Berens couldn’t figure it out. Stores still carried Nicorette gum and Nicoderm patches. Only the brand’s lozenges were gone.
And Berens, 36, was hooked. There were generic versions, but Berens and many others swore the small, white Nicorette lozenges tasted better, packed a distinct kick and took the edge off in a way no other smoking-cessation product could. Maybe it was some secret flavoring. Maybe it was just psychological. But he was as loyal to Nicorette lozenges as he had once been to his favorite cigarettes, Marlboro Reds.
“Those lozenges,” Berens says, “are magic.”
Berens and many other ex-smokers today are at the mercy of a mysterious nationwide nicotine-lozenge shortage. GlaxoSmithKline, maker of Nicorette, quietly stopped making its lozenges early last year because of quality control problems and initiated a recall, assuring curious visitors to its Web site, “you aren’t alone and we apologize.” But the pharmaceutical giant was silent about whether it would make the lozenges again.
Now, as the Nicorette lozenge threatens to disappear entirely, Berens and others are hunkering down and stocking up. They are left looking not only for lozenges but also for answers. What happens when a product that is supposed to ease addiction vanishes? And really, just how hard is it to make a lozenge?
“I wonder how many people have gone back to smoking because of the lozenge problems,” says Austin Rodrigues, a Nicorette lozenge devotee living in New York City.
Quitting smoking today is almost a rite of passage, the result of broad societal changes and laws that discourage the habit. Each year, an estimated 21 million people — about 45 percent of U.S. smokers — attempt to stop smoking. They might try electronic cigarettes or medication or the cold turkey approach. At some point, many end up turning to nicotine-replacement therapies such as the gum, lozenge or patch.
The gum accounts for slightly more than half of the $1 billion U.S. market. President Obama is one longtime nicotine gum chewer. And then there’s the lozenge, which makes up nearly a third of U.S. sales, according to Euromonitor.
Glaxo’s Nicorette brand dominates the market for nicotine gum and lozenges. The company alerted federal regulators on Feb. 20 that it was voluntarily recalling its lozenges and mini lozenges from warehouses and distributors because of quality-control problems. The company described the recalled lozenges as “overly thick, overly soft, and sub and superpotent,” according to U.S. Food and Drug Administration records.
But, the company said, the lozenges were still safe to use. So retailers could sell the remaining supply.
Nicorette introduced the nicotine lozenge to the United States in 2002, almost two decades after the gum. The gum was the original nicotine-replacement therapy, invented in the early 1970s by a Swedish chemical engineer named Ove Ferno. Swedish submariners were going stir-crazy because they couldn’t smoke on their subs. Ferno was a smoker, too. He was convinced it was nicotine, not tobacco, that drove his addiction. He first tried a nicotine aerosol spray. It tasted terrible. After much trial and error, his lab produced a palatable nicotine gum.
Ferno used his invention to break his own habit.
But not everyone likes the gum. It can stick to your teeth. And it requires work — Obama has been criticized for noticeably chewing gum during recent high-profile visits to China and India.
The nicotine lozenge just sits in your mouth, said Saul Shiffman, a University of Pittsburgh psychology professor who led the study showing U.S. regulators that the Nicorette lozenge worked at least as well as the gum. And the lozenge provides 25 percent more nicotine because it is completely absorbed, he said.
Nicotine content aside, the preference for gum or lozenge can run deep.
“Some patients complain bitterly about the taste of one or the other,” said J. Taylor Hays at the Mayo Clinic’s Nicotine Dependence Center.
But nicotine-replacement products are intended to be short-term fixes. Package inserts for nicotine gum and lozenges warn that the product shouldn’t be used for more than 12 weeks. But 6 to 10 percent of the products’ consumers use them for more than six months — in some cases, for years. Doctors generally think this is safe, especially when the other option is going back to smoking.
Berens started smoking when he was 12. He sneaked cigarettes at first, eventually developing a two-pack-a-day habit. He grew up in Oyster Bay, N.Y., the second-oldest of four children. They all smoked. His parents smoked, too. And one by one, they all quit. His mother and sister went cold turkey. His father, a lawyer, chewed the gum for years — so much that Berens swears he could see his father’s jaw muscles become more defined. Two of his brothers also chew the gum.
He was 29 when he decided to quit. Berens went with the Nicorette lozenge. “I had an epiphany,” he says.
He walked across the street to a drugstore and bought a box of lozenges, original flavor. Today, he goes through about eight lozenges a day. He might consume twice as many when he’s facing a script deadline for the CW show “Supernatural.”
As the lozenges got harder to find, Berens started buying more online. He used to shop on Amazon to save money. But the online price skyrocketed as the shortage deepened. Recently, he sat at his computer and considered an offer of a 108-count box of lozenges for $122 — almost triple the retail price. His finger hovered above his keyboard as he weighed clicking the “buy” button.
To him, this felt like smoking cigarettes. “It’s the same level of powerlessness,” he says.
And the thought of running out of lozenges has led to a few panicky moments.
“It’s dawning on me this might be a permanent situation,” he says, laughing a bit at his predicament.
Rodrigues, 34, knows the feeling. Last year, when he noticed that Nicorette lozenges were suddenly scarce in his New York City neighborhood, he called his brother in Massachusetts. They both were ex-smokers who loved the lozenges. His brother confirmed the supply problem wasn’t just local.
Rodrigues, who had been using the lozenges for three years, wanted to know more. Like any modern consumer, he took to social media, tweeting at Nicorette: “I can’t find your brand of lozenges anywhere in NYC. It’s all generic. Sup with that.”
He didn’t hear back. So he called the company. A year earlier, he’d bought $100 worth of Glaxo stock, believing that any company making a product as good as the lozenges was a solid investment. Now, he hoped the stock would earn him some traction.
“I’d never before called any company as a stockholder to demand answers,” says Rodrigues, a comedian and writer for the comedy group Upright Citizens Brigade.
He left a message. He never heard back.
“I feel like there’s a big controversy here. Something’s going on,” Rodrigues says. “Why haven’t they restarted production?”
A reporter recently called Glaxo to ask about the lozenge shortage. The company responded with a statement, explaining the lozenge-sizing problems it had at its plant in Aiken, S.C. Glaxo said it always planned to resume production, but “we did not compromise on the somewhat lengthy corrective actions.”
So it’s taken awhile. Glaxo had to change how the lozenges are made and the equipment it uses. But it expects Nicorette Mini Lozenges to return to store shelves in April. Its full-size lozenges should be back later this year.
“Oh, my God. That’s fantastic,” Rodrigues said upon hearing the news.
He just hopes he can make it until then. Already, he has resorted to visiting small, independent pharmacies in New York to hunt for lingering lozenge boxes. And he recently bought a giant bag of hard candy — like something a grandmother might stock. It wasn’t the same.
In Los Angeles, Berens counted his remaining lozenge stockpile. He had about 170 left, with many more script deadlines to go. Maybe he could stretch it out. Maybe he could just overpay online. Eventually the Nicorette lozenge would be for sale again.
But, after thinking about all he’s been through with the lozenge, he was considering one more option.
“The reality is,” he said, “I probably should get off these.”