Nicotine Patch May Help Smokers Quit
For some of the 50 million Americans who smoke, vowing to kick the cigarette habit has become a habitual New Year’s resolution.
But this time around, it might be easier--even for hard-core puffers--thanks to new nicotine patches expected to be available at pharmacies this month and to a growing body of research, which is helping to pinpoint the best strategies for quitting cigarettes and minimizing weight gain.
The Habitrol and Nicoderm patches--expected to be available in pharmacies by New Year’s Day--aim to gradually reduce dependence on nicotine. When applied to the torso, lower back or upper arm, the patch releases nicotine through the skin into the bloodstream, reducing the craving for a cigarette. The typical treatment regimen for Habitrol is three months; Nicoderm takes about 10 weeks.
The patches cost about $3 a day and are available by prescription.
In a study of the Habitrol patch, the success rates ranged from 19% to 54%, according to Ciba-Geigy, the manufacturer. For the study, success was defined as total abstinence from smoking for four consecutive weeks. Along with patch use, the smokers were advised to work closely with their physicians and to read behavioral support information included with the patches.
In a study of the Nicoderm patch, published recently in the Journal of the American Medical Assn., one of four patients who wore the largest-dose patch was a nonsmoker at the six-month follow-up. One of nine in the placebo group was a nonsmoker after six months.
The patches might help some smokers quit, but they won’t be a cure-all, warns Nina Schneider, chief of the nicotine dependence research unit at the Veterans Administration Medical Center, Brentwood division. The patch might best be used in combination with nicotine gum and behavioral strategies, Schneider says. In addition, smokers should learn coping skills for dealing with stress.
Among the ways to make quitting easier:
* Enlist the help of your doctor.
“Set a quit date with your physician,” suggests Dr. David Burns, a professor of medicine at UC San Diego, and schedule a return visit two weeks to a month later. Reminders from your doctor to quit can be powerful, says Burns, senior editor of a National Cancer Institute monograph for physicians on how to help patients quit.
The NCI guide recommends that doctors flag smokers’ charts by using colored stickers and talking to their patients regularly about the need to quit. In one study, doctors who used the sticker system had a quit rate of nearly 8%, compared to 1.5% among doctors who did not use the sticker system.
* Plan the best strategy. “Quitting cold turkey works better than tapering off,” says Erik Vidstrand, project manager of the smoking prevention and cessation program for the American Lung Assn. of Los Angeles County. “People (trying to quit) genuinely have to think like alcoholics,” Schneider agrees. They can’t think that having a cigarette now and then is harmless.
* Don’t be discouraged if this attempt to quit isn’t your first try. Smokers who relapse and then try to quit again have higher odds of success with each try, says Vidstrand.
* Know the danger periods. “The bulk of relapse occurs early, within three or four months of quitting,” Burns says. But, he adds, there are ex-smokers who have resumed the habit five or more years after quitting.
* Don’t pat yourself on the back too quickly. Schneider faults many stop-smoking programs for being too brief. After a formal program is complete, consider a weekly meeting with supportive friends or those who participated in the program with you, she suggests. Having to account to people who care about your success can be a potent motivator.
Most smokers worry about weight gain once they quit--and it’s not a groundless fear. The average weight gain is seven to 10 pounds, says Neil Grunberg, a professor of medical psychology and neuroscience at the Uniformed Services University, Bethesda, who has researched the subject extensively.
His research also has shed light on what contributes to this weight gain and how to combat it. Smokers who quit, Grunberg finds, often crave sweet-tasting foods and foods high in carbohydrates, like breads and cakes.
“Fool the body by using low-calorie or no-calorie sweeteners,” he suggests. “Sprinkle these sweeteners on everything in sight,” he says--even on chicken, if you must. The sweet tooth will abate within several weeks or at most several months, he says.
Increasing your exercise can also help minimize weight gain. Exactly how much you need to exercise, though, is speculative. Grunberg’s best guess? Add 30 minutes a day of exercise, five days a week, to whatever exercise you now perform.
And if that sounds overwhelming, Grunberg has an alternate idea: focus first on quitting smoking. Worry later, if necessary, about excess weight. A 10-pound weight gain might be emotionally devastating, but seven or 10 pounds, he says, is not enough to be a physical health hazard.
More Help for Your Lungs
If you need help kicking the cigarette habit:
* The American Lung Assn. offers free pamphlets, including “Facts About Cigarettes” and “How to Quit Smoking,” along with referrals to smoking cessation programs. Call: (213) 935-LUNG or (818) 797-LUNG.
* The American Cancer Society also has free pamphlets, including “Fresh Start.” Call: (213) 386-6102. Ask for the education office.
