Nicotine Patches, Gum, Don't Help

by Nancy Stringer

Researchers cite over-the-counter availability of these products starting in mid-1996 as the turning point. "Since becoming available without prescription in mid-1996, these products have been heavily promoted to the public," said co-author John P. Pierce, director of the UCSD Cancer Center. "Unfortunately, advertising does not distinguish between light smokers and those in the medium-to-heavy smoking category."

Also, more than a third of the most recent patch/gum users are considered light smokers -- those who smoke fewer than 15 cigarettes a day -- a group for whom these products are known to be ineffective.

This new information was compiled from the California Tobacco Surveys, which has inteviewed more than 15,000 adult smokers annually since 1990. Over the seven-year span of the surveys in the study (1992-1999), the percentage of smokers trying to quit increased by more than 60 percent. At the same time, NRT use increased more than threefold. But in contrast to 1992 and 1996, the effect in 1999 was only short term; after about three months, the effect is about the same as for those who used no aids. "When physicians prescribed these products, they likely discussed their proper use and only prescribed them for appropriate users, the moderate-to-heavy smokers," said co-author Elizabeth Gilpin. "Also, the products are designed to help with the cravings associated with smoking, but not the behavioral aspects." Pierce added: "If you believe you can't concentrate without a cigarette, the patch or gum will not help you to overcome that trigger to smoke."

The researchers write that this study "highlights the need for more research nationwide concerning the barriers to more appropriate use of NRT," and they suggest that NRTs should be used in combination with other types of smoking-cessation assistance, such as behavioral counseling.

The report appeared in the September 11 issue of the Journal of the American Medical Association.