A new study suggests cigarette smokers who quit after using over-the-counter medication such as nicotine patches are just as likely to relapse as smokers who go “cold turkey,” casting fresh doubt on the effectiveness of such products.
The finding, from a survey of several hundred smokers, could heighten U.S. smoking-policy debates at a time when the federal health-care overhaul is widening eligibility for cessation medication but states are slashing funding for public-service announcements and telephone quit lines.
Study by researchers at the Harvard School of Public Health and the University of Massachusetts Boston also coincides with a slowdown in progress, to get Americans to kick the cigarette habit, which the U.S. government says is associated with 443 000 deaths and $ 96 billion in medical expenses each year.
It is estimated that 19.3% of adults still smoke cigarettes in 2010, little changed from 20.9% in 2004. In a study published Monday in the online edition of Tobacco Control, a peer-reviewed scientific journal, the authors stated that they surveyed 787 smokers in 2001-2002, who recently threw in Massachusetts. Nearly one-third took part in the follow-up interview in 2003-2004 reported that the recurrence and nearly a third of newly reported recurrent in the third interview in 2005-2006.
The study found that smokers who used nicotine-replacement therapy in the form of patches, gum, inhalers, nasal sprays or relapse with the same speed as smokers who tried to quit without such devices. Nicotine replacement therapy, or NRT, is designed to rid smokers of cigarettes by facilitating the removal and has been available without prescription in the U.S. since 1996. Research paper strengthens the results of some other population studies in recent years indicates quitters to be higher and sometimes lower among smokers who use nicotine-replacement therapy than smokers trying to quit without help.
Gregory Connolly, one of the authors of the study, likened such smoking-cessation aids to a tricycle and cigarettes to a Mercedes-Benz, with cigarettes exerting a much more powerful pull. “It seems over the long term, smokers may gravitate back to the Mercedes-Benz from the tricycle,” said Dr. Connolly, director of the Center for Global Tobacco Control at Harvard School of Public Health.
The federal government, which aims to cut the smoking rate to 12% by 2020, advises smokers to consider using medication. The 2008 clinical practice guideline by the Department of Health and Human Services recommends health-care providers “should encourage their use” for patients attempting to quit other than pregnant women, smokeless tobacco users, light smokers and adolescents. Those recommendations are backed by hundreds of rigorous clinical trials consistently demonstrating they boost the odds of quitting, said Tim McAfee, director of the Office on Smoking and Health at the
Centers for Disease Control and Prevention.
Dr. McAfee said the discrepancy between clinical trials and population, the survey results may arise as a result of the so-called selection bias in which smokers who have a difficult time to quit is likely to turn to drugs. Population-based studies do not take this variable into account, while randomized clinical trials, to remove him. He acknowledged, however, population-based studies to raise “a very important question” about the success of end products in the “real world’ and that further research are needed.” Of course, we would like to find out why this is happening,’ said Dr. McAfee, speaking before the most recent study was published.
A CDC survey in 2010 found that 30% of U.S. smokers who tried to quit used medication and 5.9% used counseling. Only 6.2% of U.S. smokers succeeded in quitting.
Of those who used medication, 14.6% used nicotine patches, 8.9% used nicotine gum or lozenges and 1% used nicotine spray or an inhaler. Another 11.2% and 3.2% used varenicline and burping, respectively, which don’t contain nicotine. In a statement Monday, GlaxoSmithKline PLC said hundreds of clinical trials involving 35,000 people over 20 years have shown government-approved cessation products can double the success rate compared with going cold turkey. But it added there is no “magic pill” to stop smoking.