Nicotine patches don’t work in the real world, study finds

If you made a new year’s resolution to quit smoking and you’re counting on nicotine patches or gum to help you, you may want to reconsider: A new study finds that these and other nicotine replacement products aren’t much good at preventing former smokers from relapsing.

In a sample of 787 adults who had quit smoking within the previous two years, nearly one-third reported having gone back to using cigarettes. In the first wave of the study, 30.6% of recent quitters had gone back to smoking, and in the second wave of the study the figure was 31.3%. Those who had used nicotine patches, gum, inhalers or nasal sprays were just as likely to relapse as those who had quit without them.

The findings, set to be published online Monday by the journal Tobacco Control, run counter to the results of several randomized clinical trials that were conducted before the Food and Drug Administration gave the thumbs-up to these nicotine replacement products. In those trials, volunteers using such products were as much as three times more likely than volunteers who didn’t to kick the smoking habit.

However, the latest results are in line with other studies that have found little – if any – benefit for the products in real-world scenarios. In some cases, studies have found that people who use products like nicotine patches and gums are more likely – sometimes much more likely – to relapse.

“This may indicate that some heavily dependent smokers perceive NRT [nicotine replacement therapy] as a sort of ‘magic’ pill, and upon realizing it is not, they find themselves without support in their quitting efforts, doomed to failure,” the researchers wrote.

Clearly, American smokers have high hopes for the gum, patches and related products – they spend more than $1.5 billion on them each year, according to the study. Much of that money came from public health programs, which are facing further rounds of budget cuts. Policymakers ought to rethink their willingness to pay for nicotine replacement therapy, given its poor track record, and consider shifting that money to initiatives aimed at discouraging smoking in general, such as anti-smoking campaigns and efforts to raise tobacco taxes, the researchers wrote.

Not so fast, according to GlaxoSmithKline Consumer Healthcare, the company that makes Nicorette, Nicoderm and Commit lozenges, among other smoking cessation products. The company noted that most of the adults in the study who used nicotine replacement products didn’t use them for the full eight weeks that are recommended. Had those people followed those directions, they might have had more success.

“Hundreds of clinical trials involving more than 35,000 participants and extensive consumer use for more than 20 years have proven both the efficacy and safety of NRT when used as directed,” the company said in a statement. “NRT products have helped millions of smokers quit by gradually weaning them off of their tobacco addiction and is recommended as a first-line therapy for quitting.”

So if nicotine replacement didn’t help, what did? The researchers found that the quitters who had been smoke-free for at least six months were less likely to relapse than those who hadn’t reached that milestone. Getting professional counseling was helpful too, though no guarantee of success.