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Early Patch Use Helps Smokers Quit

Wearing Nicotine Patch Prior to Quitting Doubles Success
WebMD Health News
Reviewed by Louise Chang, MD

Feb. 1, 2006 -- Smokers who want to give up cigarettes may be able to double their chances of success by wearing nicotine patches before quitting, new research suggests.

Currently, the patches are not recommended for use by people who have not yet quit smoking, and researchers say it is too soon to recommend that smokers use any nicotine replacement products in this way.

"Smoking remains an enormous public health problem," says Jed E. Rose, PhD, who directs the Duke University Center for Nicotine and Smoking Cessation Research.

"A treatment strategy that doubles success rates over and above conventional ways of using the same treatment could have a significant and positive effect on public health."

Most Smokers Want to Quit

There are roughly 50 million smokers in the United States, and two out of three say they want to give up the habit for good.

Nicotine replacement products are widely used for quitting and are available in a variety of forms including skin patches, gum, nasal sprays, inhalers, lozenges, and tablets.

Because of concerns about nicotine overdose, none of the products is recommended for use by people who are still smoking, and the labeling for the products specifically warns against using them while smoking. Symptoms of nicotine overdose can range from nausea and vomiting to death.

But active smokers are exactly the people who may derive the most benefit from them, Rose says.

Rose and Duke University colleagues tested the theory in a study of 96 one-pack-a-day cigarette smokers who wanted to quit. Their findings are published in the Feb. 1 issue of the journal Nicotine and Tobacco Research.

Nicotine Patch Boosts Success

Half of the study participants wore nicotine patches two weeks prior to quitting, and the other half wore placebo patches that did not contain nicotine. People were also assigned to certain kinds of cigarettes to use for the two weeks prior to the quit date. Some smoked their regular cigarettes, some were assigned low-tar and low-nicotine cigarettes, and some received cigarettes with almost all nicotine removed. On the target quit date, the participants were assigned to receive different amounts of nicotine patches and some received placebo patches. All participants were given the smoking cessation drug Inversine.

A month later, half the smokers who had worn the nicotine patches before quitting were still not smoking, while only about a quarter of those who initially got the placebo patches remained smoke-free.

Rose tells WebMD that preliminary findings from a larger study involving 400 smokers confirm the results. He plans to present that research at the annual meeting of the Society for Research on Nicotine and Tobacco in two weeks.

A similar study by different researchers, published in 2004, included 100 smokers who wore nicotine patches two weeks before quitting and an equal number of smokers who wore placebo patches.

Six months after the target quit date, 22% of the pre-cessation nicotine patch users were still not smoking, compared with 12% of the participants who wore the placebo patches.

"All three studies suggest a doubling in the quit rate," Rose says. "That is a significant effect."

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