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Smoking Cessation Health Center

Nicotine Replacement Treatments May Not Work Long-Term

Relapse Rates Still High in Those Who Used Nicotine Replacement, Experts Say
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Nicotine Replacement Study Details continued...

The chances of relapse were not affected by use of the nicotine replacement products for more than six weeks or whether the program included counseling. The relapse odds were highest for those who had been heavily dependent on nicotine and used the products but did not get counseling.

In the past five years, the declines in adult smoking seen in previous years have stalled, Connolly says.

Deciding how best to get smokers to quit for good is a public health challenge. Sales of the nicotine replacement products have risen, Connolly says. Sales totaled $45 million in 1984, when nicotine gum was introduced. Since 1997, sales have totaled more than $800 million annually. "The findings of this study cast doubt on the relative effectiveness of NRT [nicotine replacement therapy] as a population strategy" the researchers write. The money now spent on coverage for the medications, Connolly says, should be balanced by ongoing public health programs that encourage smokers to quit.

Professor: ‘We Shouldn’t Over-Emphasize Nicotine Replacement Therapy'

Steven Schroeder MD, professor of medicine and director of the Smoking Cessation Leadership Center at the University of California, San Francisco, reviewed the study findings for WebMD.

"It's a useful reminder that there are many ways to help smokers quit and we shouldn't over-emphasize nicotine replacement therapy," he tells WebMD.

However, he sees some limitations to the study. He questions whether more participants were needed to find the true effects of the medication with or without counseling.

Another limitation, he says, is that few took the treatment as recommended.

His bottom line: "I tell [smokers] it's important to quit. Some do it cold turkey. But data show if you get counseling and one or more of the medications, it will increase your chances of quitting long-term." He is referring to previous studies showing that the combination approach helps people quit.

The study is ''seriously biased," says Saul Shiffman, PhD, professor of psychology at the University of Pittsburgh and a longtime researcher in the field. He serves as a consultant to GlaxoSmithKline, which markets the nicotine replacement products Nicorette and NicoDerm CQ.

He, too, cites the limited use of the products as a problem. He believes clinical trials, such as those that compare using the medications to not using them, give a truer picture. Numerous clinical trials, he says, ''show that these medications double your chances of quitting."

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