Many smoking-cessation experts have come to believe that wearing the patch for 8 to 10 weeks is insufficient for most smokers. In its 2008 guidelines, the U.S. Public Health Service called for more research into the effectiveness of longer-term nicotine replacement therapy. Lerman and her colleagues are now conducting another study in which quitting smokers will wear the patch for an entire year.
There’s no evidence that wearing the patch for an extended period is unsafe, says Robert A. Schnoll, PhD, the lead author of the current study. The two groups of participants in the study showed no significant differences in side effects, he points out. And, Scholl says, “Everyone would agree that it’s safer than smoking.”
Nicotine patches deliver a relatively pure dose of the drug, while cigarettes contain chemical additives that have been shown to cause cancer.
Jonathan Foulds, PhD, the director of the Tobacco Dependence Program at the University of Medicine and Dentistry of New Jersey, in New Brunswick, says the study’s findings should prompt experts to reconsider how they help people quit smoking.
“We should tailor the duration of pharmaceutical treatment for smoking cessation to the client’s needs, rather than what the box says,” says Foulds, who wasn’t involved in the study. “It’s clear that what the box says may not be long enough for some patients.”
Foulds has his patients stay on the patch until they go a full two weeks without any cigarette cravings or withdrawal symptoms. At that point, he weans them off the patch by using progressively smaller sizes.
“There’s nothing magical about 24 weeks,” he says. “The point is that staying on [nicotine replacement therapy] helps you stay off cigarettes—and, it seems, the longer the better.”
Every smoker is different, according to Lerman. Some can quit with brief treatment, she says, but others will need to stick with nicotine replacement therapy for a longer time. People who experience very severe withdrawal symptoms, for example, are likely to be better off with longer-term use, she says.
