I don’t often cover smoking on this site, but this is an interesting piece of news. The Harvard School of Public Health just released the results of a sizable study on the effectiveness of nicotine replacement therapies (patches, gum, inhalers, lozenges, nasal spray). The results:
The results showed that, for each time period, almost one-third of recent quitters reported to have relapsed. The researchers found no difference in relapse rate among those who used NRT for more than six weeks, with or without professional counseling. No difference in quitting success with use of NRT [Nicotine Replacement Therapy] was found for either heavy or light smokers.*
“This study shows that using NRT is no more effective in helping people stop smoking cigarettes in the long-term than trying to quit on one’s own,” Alpert said. He added that even though clinical trials (studies) have found NRT to be effective, the new findings demonstrate the importance of empirical studies regarding effectiveness when used in the general population.
As I said, the study was large – it followed 787 smokers who had recently quit smoking over 3 time periods between 2000 and 2006, so the results are probably trustworthy, this study has a control group – those who quit without NRT’s, and less of the trappings of those studies where the subjects are so regularly observed that the observation itself has an effect on the outcome.
What does all of this mean though? Should you use these products or not? Well, there are still benefits. Unless you’re buying generic cigarettes from a Native American reservation, then chances are nicotine replacement products are still substantially cheaper than your cigarette smoking habit – not to mention the fact that you’re no longer inhaling tar or the myriad nasty chemicals contained in cigarettes. These products must be better for your health than anything involving smoke.
Is there a downside to using NRT? I don’t know. I have personally seen, and this is only anecdotal, that the longer people stay involved with treatment programs for drug and alcohol abuse issues, the more they come to depend on those programs, and their locus of control seems to shift from believing they have the power to change their habits from within – to believing they need an outside force to change those habits – and I believe this is damaging in overcoming those habits. Perhaps, the use of NRT’s could produce the same psychological effect with cigarette smoking habits – I do not know for sure. If you’re using these though, and they seem to be helping, then I see no immediate reason to stop at this point (in the same way that I wouldn’t tell someone who is happily sober in AA to stop their involvement in the group).
Interesting Conclusions Drawn From Nicotine Replacement Therapy Findings
Perhaps more interesting than the study results though, are some conclusions drawn from the study:
“What this study shows is the need for the Food and Drug Administration, which oversees regulation of both medications to help smokers quit and tobacco products, to approve only medications that have been proven to be effective in helping smokers quit in the long-term and to lower nicotine in order to reduce the addictiveness of cigarettes,” said co-author Gregory N. Connolly, director of the Center for Global Tobacco Control at HSPH.*
The idea that lowering the amount of nicotine would reduce the addictiveness of cigarettes would never enter my mind upon reading these results. On the contrary, I think I’d conclude that nicotine has very little to do with smoking habits. I know this sounds odd, but think about it – the patch, or gum, or whatever, can deliver the same amount of nicotine as smoking – you get about 1mg of nicotine per cigarette, there are 20 cigarettes per pack, and nicotine patches come in a 21mg size. Ostensibly, if it were just about the nicotine, a pack a day smoker could just perpetually use a 21mg patch, and drastically reduce the health consequences while satisfying their nicotine addiction. However, many go back to smoking. Why is the smoking more attractive than other forms of nicotine delivery? Perhaps it’s the ritual involved, the distraction, the taste of the smoke, and/or the social aspect for some people – among other possible factors. But knowing that NRT’s are cheap and readily available, I would not conclude that reducing the amount of nicotine in cigarettes is the key to reducing cigarette addiction. There’s something more than just nicotine that people like about smoking.
* My emphasis added. See the full press release from HSPH here.
HI, Nice article but I disagree with your conclusions. Smoking is a method of getting a nicotine fix and a dopamine rush for the brain. NRT provides the nicotine but without the rush. It’s like sex without the orgasm. Eventually you want the real thing, and that’s why patches, and gum and all the other NRT products don’t work.
Good point. Wouldn’t E-Cig’s and Gums give a rush though?
I agree that smoking is not only about the nicotine. I quit and I always enjoyed the smoking part but not the smell, taste, or even the kick. You see, a while a go I started feeling really yucky after my first cig. of the day. I felt drained and sluggish after the first one. Then I had to keep them lit and going to kind of kick start myself into the day. I enjoyed sitting and smoking with friends as a social thing, but the nasty breath and trailing smell always made me feel bad about myself. I never realized how much of that smell was imbeded in my clothes,hair, car, and home.
I don’t knock people for smoking–I totally understand that people have their reasons for picking up cigarettets, but mine was a divorce that ended 12 years ago and the residue from the divorce was my smoking. I miss the smoking part, but not everything that went with it. Now after a meal, or when I feel like smoking…I suck on a tic tac and I tell my friends I’m smoking and its less than 2 calories per mint! I went cold turkey and it was difficult but I knew it was about self-control and I put down the thoughts of smoking and made it day by day…think about it, there are only 24 hours in a day so 1 day is a goal achieved! We all can do it! We all have the power–take the power back, discipline your mind and sometimes say NO to yourself out loud…You need to hear it! Blessings and prayers for all! jewels
I quit smoking 20+ years ago. I had read that the biggest trigger for someone trying to quit to light up was a habit associated with smoking. So I decided not to quit cold turkey, but to take 6 months to decouple habits from smoking. Week 1, I stopped having a cig on the way to the subway station. Once that didn’t feel like deprivation any more, I quit smoking while talking on the phone. And so on. I didn’t count how many cigs. This way, by the time I did stop smoking, I had dozens of habits no longer associated in my mind with smoking. As I said, I haven’t smoked in over 20 years.
Another interesting statistic I read: The best predictor of the success of an attempt at quitting smoking is the number of previous attempts. The corollary is that your next attempt is more likely to be successful, so it’s always worth another try.
I only have ever met people who quit cold turkey. They say nicotine replacement therapy doubles your chances. This is misleading. Cold turkey gets 3.4 and nrt gets 7.1 that is how they get the double bit. Problem is cold turkey takes on average 5.4 times and a second serious nrt attempt statistically success rate is a big fat zero. Over 90% of people quit using cold turkey it just takes them some time. NRT is not nicotine replaement but nicotine delivery and it needs to be called that.