February 2, 2011

Nicotine Replacements Help Reluctant Quitters

Nicotine gum or patches can help smokers light up less, says a new study from Hong Kong.

According to researchers, any reduction is good, because it means a lower dependence on nicotine, which will ultimately lead to an easier time quitting entirely, Reuters Health reports.

More than one thousand people participated in the study, none of whom had any immediate plans to quit smoking. Nicotine replacements -- with and without extra counseling -- led to a greater reduction in the amount of cigarettes smoked, the researchers report in the journal Addiction. More people were also able to quit completely.

About 46 million people smoke in the US, and smoking is the leading cause of preventable death in this country, killing about 443,000 Americans a year, according to the Surgeon General. The US Food and Drug Administration (FDA) does not approve of the use of nicotine patches or gum by people who still smoke, Dr. John Hughes, professor of psychiatry at the University of Vermont, who was not a part of the study, told Reuters.

"There's a notion that reduction is bad," he said. "We have to get physicians out of that mind set. In the US, and in most countries, the use of nicotine patches and gum is only for quitting. It says on (the) package "Ëœdon't use along with cigarettes,'" he said. "Eighty percent of smokers want to quit at some point, they just don't want to do it right now," Hughes said. But rather than only telling patients to quit smoking doctors should try a different approach.

The new study, by Dr. Tai-Ling Lam from the University of Hong Kong and colleagues, involved 1,154 adults who smoked about a pack a day but were not ready to quit yet. All received brief advice that they needed to quit smoking. Then 449 received a free supply of the patch or gum, and another 478 got the patch or gum plus counseling after one week and four weeks.

The nicotine patches and gum for the study were provided by Pfizer, makers of the Nicotrol nicotine inhalation system and Chantix, a smoking cessation medication. Six months after the start of the study, the researchers found that about 10 percent of those who got nicotine replacements plus counseling had quit completely.

Comparably, only 6 percent of the group that received only the nicotine replacements, and 4 percent in the people who received only the minimal stop-smoking advice had stopped smoking. In addition, after six months, half the people in the combined nicotine replacement groups had cut back on their smoking by at least 50 percent, compared to only about a quarter of the people who didn't get the gum or patches, Reuter Health reports.

Many people believe that only smoking a few cigarettes a day won't affect their health, this is incorrect, says Hughes. The health risk "seems to be much greater with first few cigarettes that you smoke. Some healthcare providers worry that if smokers start using nicotine replacement products, it will undermine their motivation to quit entirely," Hughes said.

"The important thing is for people to eventually arrive at a point where they can quit -- however they get there. We don't have to be so rigid that everybody has to do it cold turkey or abruptly," Hughes concludes.


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