Nicotine replacement ineffective

A recent study found nicotine replacement ineffective:

In the prospective cohort study the researchers, including lead author Hillel Alpert, research scientist at HSPH, and co-author Lois Biener of the University of Massachusetts Boston’s Center for Survey Research, followed 787 adult smokers in Massachusetts who had recently quit smoking. The participants were surveyed over three time periods: 2001-2002, 2003-2004, and 2005-2006. 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.

The results showed that, for each time period, almost one-third of recent quitters reported to have relapsed. The researchers found no difference in relapse rate among those who used NRT 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.

“This study shows that using NRT is no more effective in helping people stop smoking cigarettes in the long-term than trying to quit on one’s own,” Alpert said.

This is on the heels of a report that Chantix should be limited to patients who have been unable to quit with other methods.

The book Change Anything has stuck with me. The application of the model is still a little fuzzy to me, but he offers a model for change composed of six cells made up of two columns and three rows. The two columns are motivation and ability. The three rows are self/personal, social/others and structural/things/organizational. It offers a helpful way of organizing tactics, tools and strategies to change something and maintain change. And, by the way, as I learn and think more about it, 12 step recovery has evolved in ways that address all six boxes. Pretty cool.

NRT would fall into the box for structural ability but the quitter still has to attend to the other five boxes. I wonder if people using NRT are less likely to attend to other boxes for some reason.

It’s also possible that an approach that fills one box may limit approaches in other boxes. Studies have found that willingness to tolerate discomfort predicts success in quitting smoking. (personal ability) Could use of NRT indicate unwillingness to tolerate discomfort? Or, even, undermine willingness to tolerate discomfort?