Study: Nicotine gums, patches only help with withdrawal
January 9th, 2012
03:19 PM ET

Study: Nicotine gums, patches only help with withdrawal

Smokers trying to quit with the help of nicotine replacement therapies - nicotine patches, gums and lozenges - are just as likely to relapse after an initial six-month period as those who go cold turkey, according to a new study published Monday in the journal Tobacco Control.

Past studies have proven that nicotine medications are effective in helping smokers get past the physical withdrawal period when most relapse, something the study authors do not dispute. Some describe nicotine replacement therapies as rockets, launching former smokers beyond withdrawal and into orbit, where they have the same chances of kicking the habit as any other former smoker.

In fact a previous study estimates an approximately 50 to 70% greater success rate overall of quitting with a nicotine replacement than when relying on willpower alone.

But researchers at the Harvard School of Public Health take issue with what they describe to be a misperception by the public: that nicotine medications will help them with quitting after going through nicotine withdrawal.

"The perception of the public using the product is that these are good forever - that these will result in you not smoking in three, five, 10 years," says Greg Connolly, Director of the Center for Global Tobacco Control at the Harvard School of Public Health. "Well, they were never designed to do that. They were designed to treat withdrawal, which is a symptom that occurs from stopping to probably six months, and then it usually ends."

After the initial six-month window, about one-third of former smokers will relapse into smoking again regardless of whether they used nicotine medications, according to the study.

Still, more smokers will ultimately quite smoking successfully with the help of nicotine medications because more smokers will get past the very difficult early stages of withdrawal, explains Robert West, a professor with University College London's Department of Epidemiology and Public Health, who was not involved with the new study.

"The relapse rate is similar after nicotine replacement therapy (NRT) has already had it's effect," says West. "But the numbers, the absolute number of people who quit after taking NRT will still be higher."

GlaxoSmithKline, which makes nicotine replacement therapies such as Nicorette-brand gum, says it does not make any claims about long-term abstinence, but that ultimately more people will successfully quit smoking by using their nicotine products.

"The harsh reality is that more than 90% of people who attempt to quit 'cold turkey' will relapse by six months," explains Dr. Nick Kronfeld, GlaxoSmithKline Consumer Healthcare Medical Affairs Director of North America.

"By taking nicotine replacement therapy in those first few weeks following cessation of tobacco cigarettes and tobacco products, you're going to more than double your chances [of success] versus placebo. So that means when you get to your six-month point, there will be twice as many people who have successfully abstained compared to placebo."

Smoking cessation medications have been available over the counter in the U.S. since 1996, and a brochure published by the U.S. Department of Health and Human Services in 2008 recommends using nicotine gum or patches.

About 70% of current smokers say they want to quit smoking completely, according to the Centers for Disease Control and Prevention. Smoking causes about 1 of every 5 deaths in the U.S. each year.

For the study, researchers surveyed 787 adult smokers between 2001-2002, 2003-2004, and 2005-2006, all of whom had recently quite smoking.

soundoff (36 Responses)
  1. Brent

    As a family MD, I advise my patients that there are two addictions related to smoking (and dipping tobacco): 1) the nicotine addiction, and 2) the psychological dependence (i.e. to that "psychological release" that smokers look forward to when lighting up after a tense meeting etc). A nicotine replacement wean therapy is all that is needed to break the nicotine addiction. But unless the psyhcological addiction is broken, the nicotine replacement therapy will only, at best, allow someone to quit smoking for a short period.

    January 9, 2012 at 16:30 | Report abuse | Reply
  2. SixDegrees

    Interesting. After many, many failed attempts at quitting, I finally stopped reading the directions and slapped a high-strength patch on each arm, then chewed nicotine gum at the same time whenever I felt an urge for a cigarette. I dumped the patches after a couple of weeks without any withdrawal symptoms; gave up the gum after several months, cold turkey, with one or two very mild twinges the first day and nothing thereafter. I haven't smoked since, and that was about 10 years ago. Lasting or not, there is no doubt these products can get you past that initial high anxiety state. There's also no doubt that nicotine alone is nowhere near as addictive as it is when combined with other ingredients found in cigarettes. I wouldn't hesitate to recommend these products to anyone serious about quitting.

    January 9, 2012 at 16:30 | Report abuse | Reply
  3. bridgs

    I have to admit, the patch does work. I was not having great luck with the nicoderm patch as I beleive they have watered them down a bit compared to ten years ago (the first time I tried them). The doctor issued me a generic patch which I thought would not work, however it turned out to be more powerful than the nicoderm patch. Thank God!

    January 9, 2012 at 17:06 | Report abuse | Reply
  4. Big John's

    All those that have quit with the help of NRT are very lucky. It is not the intention of them to have you quit but to get you addicted to their product or to keep comming back to it with the hopes of quitting. You quit purely cause you really wanted to and were commited to quitting as I was 1 year ago. Most people with the patch on also have a smoke in their mouth. http://www.huffingtonpost.com/audrey-silk/smoking-bans_b_1181618.html

    January 9, 2012 at 18:04 | Report abuse | Reply
  5. hamsta

    Different methods work or dont work for different people regardless of what a "study" says.ive tried everything maybe i just dont want to quit or maybe the addictions that strong.i know a guy that quit by chewing on sticks.the thing that has worked best for me is the e-cigarette.i still smoke but not nearly as much.

    January 9, 2012 at 18:31 | Report abuse | Reply
    • Bob J

      I was in the same boat. The gum is what finally worked for me. I found that it was more of a routine thing with me. I would get the craving when I first woke up, then again at 8 AM, then after I ate, etc. Once I broke that cycle for a few weeks everything got easier. Eventually I ditched the gum and have been smoke free ever since. It was probably my 8th attempt but whatever works right? Keep trying.

      January 10, 2012 at 09:47 | Report abuse |
  6. Success Story

    Guess I'm one of the lucky ones. I used the Nicoderm step-down patch 14 years ago, will be 15 years in July, and have absolutely no desire whatsoever to *ever* pick up a cigarette again. Of course, I was more than ready to quit when I did – extremely tired of the expense, the cough and of being a social pariah. I can't abide being around cigarette smoke anymore or in smokers vehicles/houses. Besides at today's prices, I'd have to take a 2nd job to pay for them as well as the additional $40/mo for my insurance coverage at work.

    January 9, 2012 at 20:15 | Report abuse | Reply
  7. Greg Sims

    I have tried the patch, gum, losengers, hypnotism, lazer, Chantix and I still smoke, but I did give up coffe unintentionally, due to chantix. Chantix also sent me off into a suicidal depression. So at this point, after smoking for 47 years, I think I will continue.

    January 10, 2012 at 08:49 | Report abuse | Reply
    • tacc2

      In order to be successful, you might need to to change a few things. 1. Stop hanging around other people who smoke (at least for a little while). Seeing other people smoking and smelling the smoke is probably the #1 trigger that makes you want a cig. If you live with others that smoke, make them do it outside, away from you and don't go out to BS with them either. 2. Stop drinking (at least for a little while). Alcohol, always makes me want to smoke (and every once in a while, I'll still bum one when I'm drinking).

      It's still worth it to quit. Even after 47 years.

      Good luck.

      January 10, 2012 at 10:07 | Report abuse |
  8. tacc2

    "They were designed to treat withdrawal, which is a symptom that occurs from stopping to probably six months, and then it usually ends."

    Six months, really? From personal experience and what I've read elsewhere I believe the physical withdraw from nicotine only lasts a few days.

    January 10, 2012 at 09:54 | Report abuse | Reply
  9. NYCitizen

    It only takes 2-3 days for nicotine to completely leave your body....so after 2-3 days, it's the psychological part that makes you crazy. It's not a physical withdrawal then, it's a psychological withdrawal. Well, I have read that it takes up to 3 weeks of doing something repeatedly before it becomes a habit....so after 2-3 days, there is no nicotine in your system, and after 3 weeks, the psychological habit of smoking should be gone and a new "habit" (hopefully a healthier one) should have taken its place. Also, I can't see using NRT if even the lowest step of NRT is still stronger than the brand of cigarettes you smoke...

    January 10, 2012 at 11:11 | Report abuse | Reply
  10. Justin

    For those of you claiming that the physical effects last only a few days, please consider that this is not the only physical component. Over time your brain, i.e. the reeard center becomes accustomed to it similar to Oxycontin use. Once you quit and nicotine leaves the body it takes awhile for your brain to adjust. This is why Wellbutrin, which is an anti-depressant, is often prescribed to help with the longer term withdawal. I once quit completely cold turkey for two and a half months. I didn't know any of this about brain chemistry btw, but I definitely spun into a very dark and existential depression. I didn't know why until my father sent me a CNN medical story about the longer term withdrawal of nicotine and depression. As ashamed as I was to be such a slave to cigarettes starting up again made me feel much better. So please don't dismiss the sufferings of those trying to quit like it only takes a couple days of willpower, it is HARD to quit and I applaud those who have managed to do so!

    January 10, 2012 at 11:26 | Report abuse | Reply
  11. aj

    Well, I can happily say I gave up smoking 5 years ago. Sadly though, I'm just as addicted to the similarly expensive gum now. Breathe much better, but the nicotine addiction is still there. Now to get off this damn gum...

    January 10, 2012 at 11:53 | Report abuse | Reply
    • Darren

      I was in the same position as you. I gave up smoking over 5 years ago but until 6 weeks ago was addicted to the lozenges. I am still off the lozenges but taking one day at a time. I have occasional cravings for the lozenges but no craving for cigarettes.

      June 10, 2013 at 14:29 | Report abuse |
  12. disconnected

    He forgot to mention the hand to mouth motion and something to do with your hands. I think they should market the nicotrol inhaler. I have seen multiple people quit using it, including myself (11 years and counting). It is safe and effective, something that can rarely be said about pharmaceutical drugs. It is otc in Canada.

    January 10, 2012 at 11:55 | Report abuse | Reply
  13. NYCitizen

    Quitting Cold Turkey – According to evidence tables in the June 2000 USDHHS Guideline, a smoker's natural six-month odds of quitting "on-their-own" are roughly 10%. Education, new behavioral skills (such as adopting a one day at a time quitting philosophy), and ongoing support can easily more than triple those odds. Contrary to the marketing hype of those selling a growing array of quitting products, almost all successful long-term quitters quit smoking cold turkey (91.2%).
    Zyban – Talk to your doctor about Zyban (bupropion) should you feel the need to slightly diminish early anxieties. In clinical studies, bupropion performed roughly 15 percentage points above placebo at six months. Although its use comes with some risks, including a one in a thousand risk of seizure, they pale in comparison to smoking's risks.
    NRT – The pharmaceutical industry has not been entirely candid with smokers regarding their odds of success while using nicotine replacement products (NRT) such as the patch, gum and lozenge. A March 2003 study (Hughes) combined and averaged the seven over-the-counter nicotine patch and gum studies. It found that only 7% of study participants were still not smoking at six months. It gets worse. The odds of success appear to actually decline during a second or subsequent NRT quitting attempt. A 1993 study (Tonnesen) found that 0% of second-time patch users succeeded in quitting for 6 months and a 1995 study (Gourlay) reported a 1.6% six-month quitting rate.
    Hypnosis – A 1998 Cochrane Review of nine different hypnosis quit smoking studies concluded that "we have not shown that hypnotherapy has a greater effect on six month quit rates than other interventions or no treatment."

    January 10, 2012 at 12:35 | Report abuse | Reply
  14. Meredith Sepulueda

    Nicotine is always the bad part of cigarette smoking aside from the cancerous compounds that you can find on the smoke itself...

    Please do have a look at our favorite webpage

    November 13, 2012 at 08:33 | Report abuse | Reply
  15. Not smoking in Texas

    I quit smoking three months ago by using the step down patches. My sister quit two weeks before me going cold turkey. I'm glad I used the patches because although it was hard quitting, my sis went through more withdrawals. I didn't want to give up my morining coffee which I associated with a smoke. I didn't have to give that up, the patch helped with the cravings. I also haven't gained the weight that seems to go along with quitting. I have quit cold turkey before and went back to cigarettes because I started putting on weight. I don't wear the patches anymore, in fact I quit using them a few weeks before the program ended. We are all different so what works for me might not work for everyone. I'm glad that I quit and that I'm finally free of that awful 30 year addiction. Pat on the back for me from me!

    January 5, 2013 at 12:46 | Report abuse | Reply
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