Nicotine patch problems

The market for nicotine replacement products has been selling nicotine patches and nicotine gums for years.

However, a recent study led by Harvard scientist Hillel Alpert found that nicotine-replacing gums and patches have no lasting benefit.  In a group of 781 smokers using nicotine replacement products, almost a third relapsed.

Rick Csiernik, a professor at King’s University College who studies addiction and drug dependency, emphasizes the distinction between lapse and relapse. “Lapse is a temporary return to drug using behaviour [whereas] relapse is a more pronounced and extended return to drug using behaviour,” he clarifies.

In the past, nicotine-replacement products have been effective in helping people quit smoking in the short term. However, this effectiveness seems to be restricted to a clinical setting – in the “real world,” surveyed smokers using over-the-counter nicotine replacement products receive little benefit from the products.

The new study, which was published in the journal Tobacco Control earlier this month, also shows that nicotine replacement coupled with professional counselling offers no benefit for smokers looking to quit.

Csiernik sheds light on why relapse in smokers might be high, noting that factors affecting relapse are multidimensional. “Contributing factors to relapse can be categorized along three dimensions—biological, psychological and social,” Csiernik says.

“For smokers, the biological reasons relate to dependency liability, which relates to method of administration and the half life of nicotine combined with the behavioural reinforcement of the routine of smoking [and] socio-cultural context,” he expands.

Post-secondary students are particularly influenced by stress and intensive tobacco marketing strategies. Health Canada’s most recent statistics show that 12 per cent of Canadians between ages 15 and 19 smoke and 22 per cent of Canadians between ages 20 and 24 smoke. Programs such as Leave the Pack Behind acknowledge the prevalence of smoking in young adults and offer support.

The bottom line is that there is no simple resolution to drug addiction. “How can you expect to resolve an issue that at a minimum takes months [or] more often years to develop in days or weeks or by [using] a stick of gum or a spray?” Csiernik asks.