Why does everything that helps you quit taste like medicine?

Anyone who has tried nicotine gum remembers the taste. Peppery, slightly metallic, with a burn at the back of the throat that arrives about thirty seconds in. People describe it as tasting like a punishment, which is an interesting thing for a product to be accused of when its only job is to get used regularly for twelve weeks.

This turns out to be a more serious question than it sounds, and a more contested one.

The taste complaints are in the trial data

You don't have to take anyone's word for how these products land, because the clinical trials recorded it.

The 2018 Cochrane review of nicotine replacement therapy covered 136 studies and 64,640 participants. Set aside the summary sentence everyone quotes — the reviewers' own extracted adverse-event tables are more interesting. In one trial of nicotine gum, oral and nasal reactions were reported by 160 of 210 people on active gum, against 56 of 105 on placebo. Hiccups in the same trial: 103 of 210, against 22 of 105.

For the lozenge, the pivotal trial recorded hiccups in 16 of 459 people on the lower strength and 38 of 450 on the higher, against zero in both placebo arms.

These are individual trial figures extracted by the Cochrane reviewers, not a pooled estimate across all the evidence — worth saying, because the difference matters. But the pattern is consistent: a substantial share of people using these products have an unpleasant time in the mouth, and it's dose-related.

The format itself puts people off

The pivotal lozenge trial — 1,818 participants — opens by stating the problem it was designed to solve:

"Some smokers prefer acute oral forms, but many smokers reject chewing gum."
— Shiffman et al., Archives of Internal Medicine

That's the researchers' framing rather than something they measured in that study, so treat it as expert judgement. But it's telling that an entire product was developed on the premise that a meaningful number of people simply won't use the gum. The lozenge exists because the gum's format was a barrier.

Now the part that complicates it

Here's where an honest article about flavour has to slow down, because there's strong evidence that flavour changes behaviour — and most of it was gathered to justify restricting flavour, not celebrating it.

A 2025 overview in Addiction synthesised 32 systematic reviews on e-cigarette flavours. Its conclusion was that non-tobacco flavours may increase the appeal of e-cigarettes, increase motivation to try or continue using them, and decrease harm perceptions.

That's flavour working as a recruitment mechanism. And Australian regulators acted on exactly that reasoning: since the 2024 reforms, "flavours of therapeutic vapes have been restricted to unflavoured, mint, menthol and tobacco".

The public agrees, emphatically. In the 2025 National Drug Strategy Household Survey, 82% of Australians supported banning additives that make e-cigarettes more attractive — including 74% of 18–24 year olds, the group most affected.

And the same survey found that 19.7% of people who had ever vaped gave "taste better than regular cigarettes" as a reason for doing it — the fourth most common answer, behind curiosity, social pressure and simple enjoyment. Flavour isn't a neutral design choice. It moves people.

So what's the distinction?

It's not flavour that's the problem. It's what flavour is attached to.

Flavour attached to a nicotine delivery device makes an addictive product palatable to people who would otherwise have found it unpleasant — including, per the trial evidence on nicotine salts, people who never smoked. That's a genuine public health concern and the restrictions are a defensible response to it.

Flavour attached to something with no nicotine in it can't do that. There's no dependency for the flavour to recruit you into. The worst case is that an unpleasant task becomes slightly less unpleasant.

That's the distinction, and we think it holds. But we're not going to pretend it settles the argument, and there's one claim in particular we won't make.

What we won't claim

You could reasonably expect us to finish with "and that's why better-tasting products help people quit." We're not going to, because the evidence doesn't support it.

The same Addiction overview that found flavour affects appeal found the picture on cessation inconclusive — six reviews showed no clear impact. And when we went looking for a well-powered study proving that bad taste reduces adherence to cessation aids specifically, we couldn't find one. The closest honest statement comes from a 2024 scoping review of oral medicines, which identifies palatability as one of four recognised dimensions of patient acceptability — while noting in its own limitations that "few studies explored the impact of drug product attributes on behaviors and outcomes."

So: taste is a recognised factor in whether people accept a medicine. Whether it changes quit rates has not been properly tested. Anyone telling you otherwise is ahead of the data.

What we'll say instead is narrower and defensible. A product you don't want to put in your mouth is a product you'll use less often than the instructions say. Twelve weeks is a long time to do something unpleasant several times a day. Making it not unpleasant removes an obstacle — it doesn't do the quitting for you, and nothing does.

A note on our own position

We make a flavoured product, so we have an obvious interest in the argument that flavour matters. You should read this with that in mind, which is why we've included the evidence that cuts against us — the appeal findings, the 82% public support for restricting additives, and the absence of any proof that taste improves quit rates.

The case for flavour in a nicotine-free product is a modest one. It doesn't need to be more than modest.

If you're choosing between formats

Taste is a legitimate reason to switch products, not a frivolous one. If you abandoned gum because of the taste, that's a format problem, not a character problem. Lozenges exist for precisely that reason.

Talk to a pharmacist about alternatives. Patches, gum, lozenges, mouth spray and inhalators all exist, and they feel very different from each other.

Whatever you use, use it at the dose and frequency on the label. Under-using NRT is one of the most common reasons it appears not to work.

Quitline is 13 7848, free from anywhere in Australia, and its counsellors cover vaping as well as smoking. The Australian Government's My QuitBuddy app is free.

CURBi is a nicotine-free chewable formulated to support mood, focus and calm through the hard stretch. It contains no nicotine, so there's nothing in it to stay dependent on, and it can be used on its own or alongside nicotine replacement therapy.

CURBi is listed in the ARTG: Mixed Berry AUST L 527257 · Watermelon AUST L 527256 · Mango Passionfruit AUST L 527251. It is not a nicotine replacement therapy and does not contain nicotine, and it is not a substitute for advice from your doctor or pharmacist. Always read the label and follow the directions for use. If symptoms persist, talk to your health professional.

Sources

1. Hartmann-Boyce J, Chepkin SC, Ye W, et al. Nicotine replacement therapy versus control for smoking cessation. Cochrane Database of Systematic Reviews, 2018. Adverse event data from Appendix 3.
2. Shiffman S, Dresler CM, Hajek P, et al. Efficacy of a nicotine lozenge for smoking cessation. Archives of Internal Medicine, 2002.
3. The impacts of e-cigarette flavours: An overview of systematic reviews. Addiction, 2025.
4. Therapeutic Goods Administration. Changes to the regulation of vapes.
5. Australian Institute of Health and Welfare. Vaping and e-cigarette use, National Drug Strategy Household Survey 2025.
6. Patient Acceptability and Preferences for Solid Oral Dosage Form Drug Product Attributes: A Scoping Review. Patient Preference and Adherence, 2024.
7. Department of Health, Disability and Ageing. My QuitBuddy app.