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Nicotine Replacement Therapy No Better Than Quitting “Cold Turkey” in Preventing Smoking Relapse

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Smokers who use nicotine replacement therapy (NRT) such as patches or gum to quit are just as likely to start smoking again as those who quit “cold turkey,” according to a new study. The findings cast doubt on these products’ effectiveness in preventing relapse, The Wall Street Journal reports.

The study included 787 smokers who had recently quit. Almost one-third of those who participated in a follow-up interview two years later said they had relapsed, and almost one-third said they had relapsed a year after that. Smokers who used nicotine replacement patches, gum, nasal sprays or inhalers were just as likely to relapse as those who quit without the help of any of these products.

There was no difference in relapse rates among people who used NRT for more than six weeks, with or without professional counseling, the study found. There was also no difference in quit rates among heavy or light smokers who used NRT.

“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,” co-author Gregory N. Connolly, Director of the Center for Global Tobacco Control at the Harvard School of Public Health, said in a news release.

The federal government recommends that smokers consider using medication when they try to quit. The Centers for Disease Control and Prevention (CDC) note in a fact sheet that nicotine replacement products have been found to be effective for treating tobacco dependence. Tim McAfee, Director of the Office on Smoking and Health at the CDC, told the newspaper that hundreds of studies have shown nicotine replacement products increase the chances of quitting.

The study findings appear in the journal Tobacco Control.

5 Responses to this article

  1. Patti Herndon / January 11, 2012 at 8:24 pm

    This is good food for thought. Thanks for relaying the info on nicotine replacements, Join Together/Partnership.

    And BIG thanks to Ben for mentioning Prochaska’s Stages of Change Model:pre-contemplation, contemplation, preparation, action, and maintenance.

    Go for it:Google ’til ya get it -”Prochaska and DiClementi’s Stages of Change Model”. It’s logic-making, ability-building stuff.

    People will cycle through specific stages of change until they reach sustainable nicotine-free lifestyle. Sometimes that means moving through a stage of change or two, then back one. But, we need to learn to not fixate on that ‘one back’ as being ‘failure’…. because that “one back” indicates that there is reason/necessity to repeat/strengthen the behavioral learning/modification process. It’s a VERY individual process -that journey. But that process will result in sustainable change…little by little.

    We are too impatient about the individual’s change process regarding addiction in our society. That impatience equates to increased anxiety about use…which triggers more use. Talk about a cycle to break- the impatience and anxiety cycle.

    There are multiple studies that support Prochaska and Diclemente’s framing of change, and the process by which it occurs.

    If using nicotine replacement helps an individual manage the stress that comes with change process, resulting in increasing self-efficacy/belief in their ability to achieve the change they desire…then, making use of a nicotine replacement shouldn’t be viewed as negative. It’s up to the individual to decide what serves their change process. The most helpful thing for everyone else to do in support is encourage the individual.

    People achieve freedom from nicotine, as well as sustainable sobriety in terms of alcohol and drug use…all the time. We just don’t tend to hear about those successes as much.

    We live in a culture that’s patterned to focus on perceived failure/powerlessness…’can’t-factor’ associated with addiction. It seems fairly typical that we collectively focus our attention on the things that can go wrong, instead of the reality that people are VERY capable of healthy, sustainable change. It’s process that takes as long as it takes.

    Stages of Change process:This is key to behavioral modification, thus relapse prevention. Checkout “Motivational Interviewing” as a potential source for learning about your own,individual change process in ‘kicking the habit’.

    But, whether you choose a nicotine replacement or not…Keep on keepin’ on. You’ll get there. Believe it. To supercharge your efforts, surround yourself with people who will CONSISTENTLY encourage your efforts -thus supporting momentum through the change process and minimizing the stress and anxiety that triggers coping with nicotine and/or other substances.

  2. Ben House / January 11, 2012 at 1:29 pm

    When the treatment focus is only on the chemical dependency element (NRT)it is missing one of the most vital components of smoking, the habituation element. Smoking is both a ritual behavior and a pastime behavior and until the smoker finds new rituals and ways to pass time they are at risk for relapse. Since the half life of nicotine is just a few days I teach cut back by half as the client develops new behaviors to replace the nicotine use over a period of time similar to the step down program of the NRT’s. Then following Prochaska’s change model follow in maintenance until the change is habituated.

    NRT’s are marketing gimmicks, duh. I am happy someone published this bit of information.

  3. Avatar of Dudley
    Dudley / January 10, 2012 at 11:44 pm

    WTF does nicotine replacement or no nicotine replacement have to do with relapsing anyway?!! That is all in the mind, just like the addiction itself. That article makes no sense at all. Maybe you should spend more time writing about things that actually MEAN something.

  4. Fred C, / January 10, 2012 at 1:08 pm

    So What’s the point here? It seems the research is saying that after they have quit and are no longer using Nicotine Replacement Therapy, that they are just as likely to relapse as those who have used a different method to quit. I didn’t realize that NRT ever claimed to prevent relapse after you quit using it. does any other drug or therapy claim that you will not relapse after you quit using it? The last I heard, it took an average of 7 tries before quitting smoking became successful. It doesn’t seem like anything has been found effective to permanently prevent relapse.

  5. Dudley / January 10, 2012 at 11:46 pm

    I strongly agree Fred!! WTF were they thinking when they posted this Anyway?!! Duh!!

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