Gum, patches help reluctant quitters smoke less

When smokers don’t want to quit, nicotine gum or patches can help them smoke less, says a new study from Hong Kong.

And any reduction is good, because it means a lower dependence on nicotine, which will ultimately lead to an easier time quitting entirely, according to the researchers who conducted the study.

Among the more than one thousand participants 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.

But the U.S. Food and Drug Administration does not approve of the use of nicotine patches or gum by people who still smoke, said Dr. John Hughes, professor of psychiatry at the University of Vermont, who was not a part of the study.

“In the U.S., and in most countries, the use of nicotine patches and gum is only for quitting. It says on (the) package ‘don’t use along with cigarettes,’” he said.

About 46 million people smoke in the U.S. Smoking is the leading cause of preventable death in this country, killing about 443,000 Americans a year, according to the Surgeon General.

“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 telling their patients to quit smoking over and over again, maybe doctors should try something different.

“There’s a notion that reduction is bad,” he said. “We have to get physicians out of that mind set.”

Nicotine replacement products, either gum or patch, typically cost about $20 to $25 a week.

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 and wanted to cut back, but weren’t ready to quit yet.

All received brief advice that they needed to quit smoking. Then 449 got 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, compared to 6 percent in the group that got just the nicotine replacements, and 4 percent in the people who received only the minimal stop-smoking advice.

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.

Several studies in the past have shown similar results, but this is the first to look at both patches and gum, and the first large study in China, where more than 300 million people smoke, according to the World Health Organization.

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