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Nicotine
Patches, Gum Less Effective
NEW YORK (Reuters Health) - Now that nicotine replacement therapy
such as nicotine patches and gums are sold without a prescription,
they may be less effective at helping smokers kick the habit for
good, new study findings show.
One problem is that most people who buy these products don't
use them for 6 weeks--the minimal time recommended, according
to the report. However, it is also possible that nicotine replacement
therapies are not as effective as once thought.
"This study adds to concerns that the efficacy of pharmaceutical
aids observed in clinical trials may not extend to effectiveness
in the general population," according to Dr. John P. Pierce and
Elizabeth A. Gilpin of the University of California, San Diego.
The authors published their findings in the September 11th issue
of The Journal of the American Medical Association.
Pierce and Gilpin obtained their results from a review of three
recent tobacco surveys conducted in California between 1992 and
1999, each of which asked between 5,000 and 10,000 people about
their tobacco use.
The investigators found that the proportion of smokers who tried
to quit increased by 61%, from 38% in 1992 to 62% in 1999. The
proportion of people opting for nicotine replacement therapies
to help them quit also increased by 50% during the same period,
from 9% to 14%. In 1999, a total of 17% of quitters were using
nicotine replacement therapy, an antidepressant, or both to help
them butt out for good.
The authors note that nicotine replacement therapy appears to
help moderate to heavy smokers (at least 15 cigarettes per day)
quit in the short-term. However, the nicotine replacement therapies
appeared to offer no boost in users' chances of kicking the habit
for good once the products became available over-the-counter in
1996.
In addition, Pierce and Gilpin write that they could find no
benefit of nicotine replacement therapies in helping light smokers
quit, either in the short- or long-term. Almost 60% of the people
included in the tobacco surveys were classified as light smokers.
Despite the apparent lack of benefit of the products, sales
increased more than threefold from 1992 to 1999, the report indicates.
Pierce and Gilpin suggest that trials of nicotine replacement
therapy may have included people who were more motivated to quit
than smokers in the general population, or may have been too generous
when determining whether or not a former smoker had quit for good.
In one study, smokers were considered to have quit if they were
abstinent for at least 1 week at 5 months.
According to GlaxoSmithKline, a maker of nicotine replacement
products, previous studies have demonstrated that over-the-counter
nicotine replacement therapies can increase a smoker's chances
of quitting just as well as when the products require a prescription.
Furthermore, previous research has shown that using nicotine replacement
products can double a smoker's chance of quitting, relative to
those who try to butt out without relying on the products.
"Quitting smoking can be a tough challenge for many smokers,
but the results from California should not discourage smokers
from striving to escape their tobacco dependence and using clinically
proven cessation aids and behavioral support to increase their
chances of success," the company said in the statement.
SOURCE: The Journal of the American Medical Association 2002;288:1260-1264.
Reference
Source 89
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