Smokers trying to quit with the help of nicotine replacement therapies – nicotine patches, gums and lozenges - are just as likely to relapse after an initial six-month period as those who go cold turkey, according to a new study published in the journal Tobacco Control.
Past studies have proven that nicotine medications are effective in helping smokers get past the physical withdrawal period when most relapse, something the study authors do not dispute. Some describe nicotine replacement therapies as rockets, launching former smokers beyond withdrawal and into orbit, where they have the same chances of kicking the habit as any other former smoker.
In fact a previous study estimates an approximately 50 to 70% greater success rate overall of quitting with a nicotine replacement than when relying on willpower alone.
But researchers at the Harvard School of Public Health take issue with what they describe to be a misperception by the public: that nicotine medications will help them with quitting after going through nicotine withdrawal.
"The perception of the public using the product is that these are good forever - that these will result in you not smoking in three, five, 10 years," says Greg Connolly, Director of the Center for Global Tobacco Control at the Harvard School of Public Health. "Well, they were never designed to do that. They were designed to treat withdrawal, which is a symptom that occurs from stopping to probably six months, and then it usually ends."
After the initial six-month window, about one-third of former smokers will relapse into smoking again regardless of whether they used nicotine medications, according to the study.
Still, more smokers will ultimately quite smoking successfully with the help of nicotine medications because more smokers will get past the very difficult early stages of withdrawal, explains Robert West, a professor with University College London's Department of Epidemiology and Public Health, who was not involved with the new study.
"The relapse rate is similar after nicotine replacement therapy (NRT) has already had it's effect," says West. "But the numbers, the absolute number of people who quit after taking NRT will still be higher."
GlaxoSmithKline, which makes nicotine replacement therapies such as Nicorette-brand gum, says it does not make any claims about long-term abstinence, but that ultimately more people will successfully quit smoking by using their nicotine products.
"The harsh reality is that more than 90% of people who attempt to quit 'cold turkey' will relapse by six months," explains Dr. Nick Kronfeld, GlaxoSmithKline Consumer Healthcare Medical Affairs Director of North America.
"By taking nicotine replacement therapy in those first few weeks following cessation of tobacco cigarettes and tobacco products, you're going to more than double your chances [of success] versus placebo. So that means when you get to your six-month point, there will be twice as many people who have successfully abstained compared to placebo."
Smoking cessation medications have been available over the counter in the U.S. since 1996, and a brochure published by the U.S. Department of Health and Human Services in 2008 recommends using nicotine gum or patches.
About 70% of current smokers say they want to quit smoking completely, according to the Centers for Disease Control and Prevention. Smoking causes about 1 of every 5 deaths in the U.S. each year.
For the study, researchers surveyed 787 adult smokers between 2001-2002, 2003-2004, and 2005-2006, all of whom had recently quite smoking.