TUESDAY, Sept. 10, 2002 (HealthDayNews) -- A new survey suggests nicotine patches and gum alone have become virtually useless for quitting smoking for good, apparently because doctors no longer supervise their use.
"Nicotine addiction isn't just a physiological addiction. It's a psychological one, too," says study co-author John P. Pierce, director of the Cancer Prevention and Control Program at the University of California at San Diego Cancer Center.
"Unless you handle the problems and the issues that are behind why you're using smoking as a crutch, sooner or later the patch isn't going to work," he says.
However, the maker of the NicoDerm and Nicorette brands of anti-smoking patches and gum says the findings conflict with earlier studies. In smokers who don't take part in behavioral therapy, use of nicotine-based products appears to double the chances smokers will be able to quit, GlaxoSmithKline says in a written response to the study.
The results of the study appear in tomorrow's issue of the Journal of the American Medical Association.
Nicotine gums and patches have been available over the counter since 1996. The products let smokers slowly wean themselves off their addiction by getting doses of nicotine without having to light up.
In the new study, researchers examined data from the California Tobacco Surveys of 15,000 adult smokers taken in 1992, 1996 and 1999. "We took the smokers and looked at their quitting behavior, whether they used anything to help them quit, and how effective it was," Pierce says.
In 1992 and 1996, smokers who used nicotine patches or gum were more likely than other smokers to be able to quit for long periods of time. However, in 1999, users were no more likely than other smokers to remain cigarette-free after three months.
Pierce suspects more light smokers -- those who smoke fewer than 15 cigarettes a day -- are incorrectly using the products because they no longer require a doctor's prescription.
"The patch has never been shown to be helpful to them," he says.
On the positive side, Pierce says smokers who are trying to quit can indeed get benefits from the patch, whether or not they enter behavior-modification programs. They just must find some way to deal with the psychological cravings, he adds.
"People associate a lot of things with smoking. They can't relax without it," he says. "In those situations, you've got to replace smoking with something else and feel that you're getting the same benefit."
For example, if a writer can't write without puffing away on a cigarette, "you've got to come up with some other way of handling that problem," he says.
In its statement, GlaxoSmithKline pointed out the U.S. Public Health Service has recommended nicotine patches and gum for nearly all smokers, even light ones who smoke 10 or fewer cigarettes a day. Light smokers should simply start with lower doses, the company says.
The California study shouldn't "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 states.
What To Do
For more stop-smoking strategies, visit QuitNet. For a fact sheet on nicotine-replacement products, go to The American Lung Association.
