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Harvard School survey asserts NRT ineffective in spite of body of evidence to the contrary


BOSTON — Nicotine replacement therapies designed to help people stop smoking, specifically nicotine patches and nicotine gum, do not appear to be effective in helping smokers quit long-term, even when combined with smoking-cessation counseling, according to a new survey by researchers at Harvard School of Public Health and the University of Massachusetts Boston posted in an advance online edition of Tobacco Control Monday.

"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,” stated co-author Gregory Connolly, director of the Center for Global Tobacco Control at HSPH.

The study, with only 787 interviewees, pales in comparison to the body of research encompassing more than 35,000 subjects that does establish appropriate efficacy. Participants were asked whether they had used a nicotine replacement therapy in the form of the nicotine patch (placed on the skin), nicotine gum, nicotine inhaler or nasal spray to help them quit, and if so, what was the longest period of time they had used the product continuously. They also were asked if they had joined a quit-smoking program or received help from a doctor, counselor or other professional.

"Despite the authors' conclusions, there remains strong support for NRT's efficacy and its positive impact on public health," countered GlaxoSmithKline, manufacturer of Nicorrette, in a statement released Monday. "Leading experts in the field of smoking control, nongovernmental bodies, such as the World Health organization, and many governments around the world, agree that NRT products have a crucial role to play in helping to reduce the devastating toll of disease caused by tobacco dependence," GSK stated. "Additionally, the 2008 U.S. Public Health Service Guideline, 'Treating Tobacco Use and Dependence,' recommends NRT products as a first-line therapy for quitting, as they 'increase significantly rates of long-term smoking abstinence.'"

According to the Harvard School survey, almost one-third of recent quitters reported to have relapsed. The researchers found no difference in relapse rate among those who used nicotine replacement therapy for more than six weeks, with or without professional counseling. No difference in quitting success with use of NRT was found for either heavy or light smokers. GlaxoSmithKline added that 97% of those smokers who attempted to quit "cold turkey" also relapsed and began smoking again.

"When it comes to smoking cessation, there is no 'magic pill'. Quitting smoking requires a combination of pharmacotherapy and behavioral support," GSK stated.


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