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NRT fails to reduce relapse rates in long-term

By News team

Nicotine replacement therapy does not help to reduce relapse of ex-smokers in the long-term, according to researchers at Harvard School of Public Health, Massachusetts.

Analysing data for 787 adults who had quit smoking within the previous two years, they found that the number of people who remained smoke free dropped by almost a third between each follow-up interview, which were spaced around two years apart.

Individuals were asked whether they had used NRT in the form of patch, gum, inhaler or nasal spray to help them quit. The researchers found that the odds of relapse were unaffected by NRT use for more than six weeks, either with (P=0.117) or without (P=0.159) professional counselling. The same finding was observed for people who used NRT for any length of time. Those who had been heavy smokers and had used NRT for any length of time, but had not received professional counselling, were twice as likely to relapse compared with those who did not use NRT (odds ratio 2.68, confidence interval 1.40–5.11).

The study authors say that this might "indicate that some heavily-dependent smokers perceive NRT as a sort of magic pill, and upon realising it is not, they find themselves without support in their quitting efforts, doomed to failure."

The study also reports that few quitters follow the recommendation of using NRT for eight weeks — just over 33 per cent had used NRT for more than six weeks at the first wave of interviews, and under 35 per cent at the second wave.

Terry Maguire, a Belfast-based community pharmacist and smoking cessation expert, told The Journal that the study is at odds with randomised controlled trials that have been used to date as evidence of the efficacy of NRT. However, "it has been known for many years that relapse in smoking cessation is high at 12 months post-quitting, with often much less than 20 per cent of those who have stopped remaining [smoke-free]," he added.

Dr Maguire said the findings question the relative effectiveness of smoking cessation services.

"Money might be more effectively spent on comprehensive public health programmes such as changes to social norms, mass-media campaigns, smoke-free laws and restrictions on advertising," Dr Maguire suggested.

The study was published online in the BMJ journal Tobacco Control (10 January 2012).

Citation: The Pharmaceutical Journal URI: 11092895

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