SAN DIEGO, Sept. 10 (UPI) -- Increasing sales of over-the-counter nicotine replacement therapies do not help some smokers quit for the long-term, particularly light smokers, a new study released Tuesday suggests.
Cancer researchers at the University of California at San Diego School of Medicine reported since the nicotine patch and nicotine gum became available without a prescription six years ago, their use has skyrocketed. During this period, however, the number of people who have been able to kick their smoking habit completely by using these products has declined.
Researchers also found light smokers -- people who smoke 15 or fewer cigarettes per day -- were least likely to benefit from the over-the-counter products, though these smokers represent one-third of the market for the patch and gum.
"The big problem of course is that nicotine patches have never been a magic bullet -- they were never meant to be," co-author John Pierce, director of UCSD's Cancer Prevention and Control Program, told United Press International. NRT products can help ease the physiological dependence, he said, "but there's a psychological dependence" they are unable to treat.
Researchers analyzed information compiled from the California Tobacco Surveys, taken among state residents every year since 1990. Researchers focused on 1992, 1996 and 1999. During those years, more than 15,000 smokers in California were interviewed and asked about their attempts to quit, if they had used a pharmaceutical aid to quit and how long they remained off cigarettes the last time they quit.
From 1992 to 1999, the number of smokers trying to quit rose from 38.1 percent to 61.5 percent. Simultaneously, customers for NRT products increased threefold -- totaling 423,390 in 1999, compared with 116,209 in 1992. Of the increased population of would be non-smokers in 1999, 37 percent were from the light-smoking group.
Further analysis indicated NRTs provided a significant effect for many smokers. Compared with 1992 and 1996, however, the effect in 1999 was only short term -- after about three months, users of NRTs had no greater success kicking the habit than those who used no anti-smoking aids.
The researchers pointed out that when these products were available only by prescription, physicians would discuss their proper use with patients and only prescribed them to moderate-to-heavy smokers. Also, the products are designed to help ease nicotine cravings, but do not address the behavioral and psychological triggers associated with smoking. For example, for people who cannot concentrate without a cigarette, the patch or gum probably will not help, researchers said.
Light smokers have fewer withdrawal symptoms than heavier smokers, Pierce explained, which may help explain why over-the-counter products that help treat nicotine withdrawal do not work as well for light smokers.
"It's never worked in light smokers, but in their advertising, (the manufacturers forget) to mention all that," he said, commenting that advertisers should make this disclosure to light smokers.
Patricia Chandler, an addiction specialist and family medicine physician at the University of Texas Southwestern Medical Center at Dallas, disagreed.
Although it is true light smokers do not have the severity of addiction heavier smokers have, Chandler said the evidence is overwhelming over-the-counter nicotine withdrawal therapies can help any smoker. "It really depends on the motivation of the patient," Chandler told UPI.
"I don't think the study is set up in any way that you can draw any conclusions," she added. "It's just one study. (The products) are effective and it doesn't make any difference how many cigarettes you're smoking."
The study is published in the Sept. 11 issue of Journal of the American Medical Association.
(Reported by Katrina Woznicki, UPI Science News, in Washington)
