16 April 2012

Nicotine patch may help prevent smoking relapses

Nicotine patches may help smokers recover from any initial setbacks in their attempt to kick the habit, a new study suggests.


Nicotine patches may help smokers recover from any initial setbacks in their attempt to kick the habit, a new US study suggests.

"The clear implication is that you shouldn't give up, you should stay on the treatment with patch," said senior investigator Dr Saul Shiffman, from the University of Pittsburgh.

Contrary to common perception, people who give in to a craving for tobacco during nicotine replacement therapy haven't necessarily failed at quitting and may get over initial lapses by continuing to use the patch, Dr Shiffman said.

His team's study, published online in Addiction, suggests that along with helping people stop smoking in the first place, nicotine patches could also boost their chances of recovering from occasional lapses while trying to quit.

Experts say most people trying to break the habit manage to do so at first, but are unable to sustain their quit attempt over the long run. "Patch can help overcome these lapses. We're ignoring what could be a very important benefit of treatment," Dr Shiffman said.

Use nicotine even after setbacks

In a post hoc analysis, Dr Shiffman looked at 509 heavy smokers enrolled in a placebo-controlled trial of nicotine patches. Each of these participants had reported lapsing back to smoking at least once during the trial.

The researchers found that active patch users were better able to rebound from a lapse than those on the placebo. At week six, people treated with nicotine patches were 11 times more likely than those wearing placebo patches to have stopped smoking for at least a week before their visit.

Similarly, in week 10, close to 10% of active patch users reported abstaining from cigarettes for at least a week, versus between 2% and 3% of placebo users.

The research was funded by GlaxoSmithKline, which markets nicotine replacement therapy products. The study authors also act as consultants to the company and have a stake in efforts to develop new smoking-cessation drugs.

According to Dr Shiffman, the findings suggest smokers trying to quit should keep using a nicotine patch even after setbacks, rather than stop wearing it because of the mistaken belief that using patches and cigarettes together poses a health danger.

Patch while smoking discouraged

Most experts and package labels do discourage using the patch while smoking cigarettes, to avoid nicotine overdose. But Dr. Shiffman said warnings on nicotine replacement therapies against simultaneous use merely offer common-sense advice against smoking while using such products to beat the habit, he added.

"There is really no particular risk," he said, adding that people incorrectly interpret the label to mean the combination is dangerous.

Dr Alvin Strelnick, chief of community health at Albert Einstein College of Medicine in the Bronx, said the new study confirms a position supported by experts in the field – namely, smokers should not give up on nicotine patches just because they lapse once or twice during their quit attempt.

But he cautioned that, as noted in the study, it can be tricky to re-analyse data from prior research that was designed for another purpose.

Dr Strelnick, who wasn't involved in the new study, told Reuters Health that the optimal protocol for smoking cessation combines the longer-acting nicotine patch with shorter-acting products like nicotine gum, nasal spray or lozenges,

"That more closely mimics the way in which nicotine is (present) in the body of most smokers," he said.

(By Aparna Narayanan, Reuters Health, April 2012) 

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Long- term benefits of nicotine patches


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