Longer nicotine-patch therapy may extend abstinence

Smokers who use nicotine patches for longer than the standard eight weeks may stay off of cigarettes for a longer period as well, a study published Monday suggests.

The study, of 568 adults looking to quit smoking, compared the effects of standard nicotine-patch use with extended therapy - that is, six months versus the two months recommended by manufacturers.

After six months, researchers found, about 32 percent of patients on extended therapy were abstinent, compared with only 20 percent of those who had stopped using the patches after two months.

And when patients did fall off the wagon and start smoking again, those on the extended patch therapy were more likely to get back on the wagon during their treatment period, according to findings published in the Annals of Internal Medicine.

However, once patients stopped using the patches, the benefits of extended therapy faded. One year into the study, 14 percent were still abstinent - identical to the percentage in the standard-therapy group.

The implication, the researchers say, is that extended therapy can lead to extended abstinence, at least as long at the treatment is maintained.

"At the end of the treatment period, there were significant and clinically meaningful differences" between the groups, said senior researcher Dr. Caryn Lerman, a professor of psychiatry at the University of Pennsylvania in Philadelphia.

She said more research is necessary to see what the optimal duration of nicotine-patch therapy is - though that, Lerman pointed out, will vary from person to person.

The researchers say that studies should also look at whether additional therapies, such as intensive behavioral counseling or medication, boost the long-term success of extended patch use.

No single quit tactic works for everyone, and a number of studies have suggested that some smokers do better on a combination of therapies.

A study published last month of more than 1,300 quitters found that 30 percent of those on nicotine lozenges plus the drug bupropion SR (a sustained-release form of Zyban) were still smoke-free six months after starting their quit attempt - as were 27 percent of those who used nicotine patches plus lozenges. That compared with 17 percent and

18 percent, respectively, of patients on the drug or patch alone.

For the current study, Lerman and her colleagues randomly assigned 568 quitting hopefuls to use 21-milligram Nicoderm CQ patches for either the standard eight weeks or 24 weeks. Those on the standard therapy were given placebo (inactive) patches for the rest of the treatment period. All patients were also offered behavioral counseling - every couple weeks to get started, and then monthly.