Landmark study finds nicotine gum, patch fail smokers

Smokers hoping to kick the habit for good this New Year be warned: a new study says the patch is no more effective than quitting cold turkey.

Researchers at Harvard University and University of Massachusetts Boston found that nicotine replacement therapies, including the patch, gum, inhaler or nasal spray, did little to help smokers quit in the long term and in some cases, worsened the habit.

“We would have liked to see that (nicotine replacement therapies) were effective in abstinence because the toll smoking takes is devastating. But unfortunately, we see that this approach is not the answer,” said co-author Hillel Alpert of the Harvard School of Public Health.

Yet these therapies, long supported by medical studies as effective, remain a centrepiece of anti-smoking programs and policies in both the U.S. and Canada.

More than 68,000 smokers in Ontario have received nicotine replacement therapies free since 2005 under the government-funded Smoking Treatment for Ontario Patients program. In July 2011, the Ontario government introduced a $3-million project that provides free, over-the-counter nicotine replacement therapies and counselling to smokers.

But in the first study of its kind, published Monday in the journal Tobacco Control, U.S. researchers examined the long-term effects of nicotine replacement therapies in nearly 800 adults in Massachusetts who had quit smoking in the previous two years, and found little benefit over a six-year period.

“(Nicotine replacement therapies) are intended to treat withdrawal in the short term. They’re not the silver bullet to help you quit,” said Gregory Connolly, director of the Center for Global Tobacco Control at the Harvard School of Public Health, co-author with Alpert and Lois Biener of the University of Massachusetts Boston.

The smokers, surveyed three times between 2001 and 2006, were asked whether they used a nicotine replacement therapy, how long they used the therapy and whether they joined a quit-smoking program or consulted with a professional to help them quit.

At each stage of the survey, researchers found that nearly a third of people who had used a nicotine replacement therapy had relapsed. Heavy smokers who used nicotine replacement therapies without professional counselling were twice as likely to return to smoking, according to the study.

The findings cast doubt on publicly-funded programs that tout nicotine-replacement therapies as an effective way to curb smoking, said Connolly.

For Peter Selby, head of the Centre for Addiction and Mental Health’s nicotine dependence clinic in Toronto, nicotine replacement therapies are critical in helping vulnerable populations wean themselves off cigarettes.

“Medication is not the only answer, but it’s part of a comprehensive approach,” said Selby.

“In a country like Canada where the burden of smoking is borne by people who can least afford to smoke, you need to have options for them to get help,” adds Selby, lead investigator on the provincially funded Smoking Treatment for Ontario Patients study, which provides the therapies free to smokers in the study.

Therapies could help people in the early stages of quitting, said Connelly, but, based on the latest research, they don’t appear to be sustainable.

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