Nicotine patches, lozenges help heavy smokers, too

Even highly addicted smokers are helped in their efforts to quit when they use nicotine patches and lozenges to wean themselves off the habit, new research shows.

Some experts have doubted whether nicotine patches or lozenges - termed nicotine replacement therapy (NRT) - can work for heavy smokers, since they're used to much more nicotine than NRT can provide, study author Dr. Saul Shiffman explained.

However, even for more moderate smokers, NRT does not replace all the nicotine they got from smoking cigarettes, Shiffman noted.

And what works for them appears to work for heavy smokers, as well.

"Our analysis showed that the lozenge and patch, at normal doses, were effective for these very heavy smokers," said the researcher, based at Pinney Associates in Pittsburgh, Pennsylvania.

Smokers who want to quit should also consider seeking help from experts to change their behavior, Shiffman added.

"Smokers - even those who are not very heavy smokers - should take away a message of hope that there is help available, and they should use it," he told Reuters Health.

The study was sponsored by GlaxoSmithKline, which makes nicotine patches, gum and lozenges.

Shiffman explained that when people smoke, their brains become adapted to nicotine. So when they stop smoking, they get cravings and symptoms of withdrawal, such as irritability and trouble concentrating.

"The nicotine patch and lozenge provide just enough nicotine to 'take the edge off' these symptoms," Shiffman noted, enabling people to concentrate on quitting smoking. And it's not nicotine that is harmful for smokers, he added - smoking kills because of the thousands of carcinogens and toxins found in cigarettes.

In the Journal of Substance Abuse Treatment, Shiffman and his colleagues write that experts have not fully examined how well NRT products work in subgroups such as heavy or highly addicted smokers.

To investigate, the researchers reviewed two previously conducted studies of NRT. In the first study, 502 people were either given the patch or a placebo, and treatment to modify their behavior. In the second trial, 901 people received either lozenges or placebo lozenges, along with behavior treatment.

The researchers found that people who smoked at least 40 cigarettes daily were more likely to stay smoke-free for 6 months if they used the patch or lozenges. People who were very addicted to cigarettes were also more likely to quit using either the patch or lozenges.

"Medicinal nicotine products like patch and lozenge are effective in helping people quit, and can help even those who are very heavy smokers," Shiffman concluded.

SOURCE: Journal of Substance Abuse Treatment, January 2005.