Is Nicotine Replacement Therapy The Answer To Quitting Smoking
Nicotine replacement therapy (NRT), or continuing use of nicotine in other forms and at lower dosages, comes to mind first as a stop smoking remedy. However, this has not been measured in terms of permanent (lifetime) withdrawal, and even using the typical six-month to one-year abstinence criterion it is not as effective as the advertising hype suggests.
In light of the particular addictive properties of nicotine - whatever the dosage or method of intake - this should be blatantly obvious. Continued physical addiction is guaranteed, for instance, by feeding more of the addictive drug. That’s the way addictive drugs work. Worse than that - the craving and stress tend to increase because of the lower, shorter lasting relief. So giving up the drug gets ever harder.
Meanwhile, cigarette manufacturers face a rearguard (though still profitable) action, as sales of NRT products such as patches, gums and inhalers increase apace. ‘It’s an ill wind…’.
This illustrates the almost miraculous, all-pervasive impact of marketing on the sales of both cigarettes and so-called non-smoking remedies. ‘Cures’ involving such products are often short-lived, and thus meet the basic requirement of the commercial success of the product - repeat sales.
Even in the case of NRT the most cited research adopts a six month cut-off point as a ‘cure’ or ‘cessation’. But ’smoking cessation’ applies to cigarettes rather than nicotine, the addictive element in the cigarettes, which the product perpetuates. Extraordinarily, the smoking public accepts remedies that patently fail in the majority of cases, simply because they are ‘accepted’ remedies.
More recently on the market, NRT lozenges fall into the same general category, except that they contain a higher dose of nicotine, so as with all NRT products they perpetuate the physical addiction. As they can be more precisely linked to the ups and downs of the craving than patches, and involve doing something, these may help in replacing part of the habitual aspects of smoking, much like sucking mints does, but it is too early to judge.
Patches and gums generally claim approximate doubling of the chances of success (measured-against the research period of perhaps six months). This is from a very low base line, however, and thus falls near to willpower on the withdrawal success ladder.
Most significantly though, research into these products is almost always linked with some other interpersonal intervention, such as advice, counseling, or a helpline type resource. In fact, it is almost impossible to isolate remedies such as NRT from other variables such as:
- willpower
- motivation
- recourse to family and friends for support
- a recent event increasing the desire to quit
- circumstances such as a new car you want to keep fresh-smelling
- present stressful life circumstances
- a Job that precludes smoking
- the smoker’s immediate social circle
- a recent smoking-related bereavement
- the burden of the expense of buying cigarettes.
Widely used stop smoking remedies such as patches and gums may actually make the problem worse by perpetuating the addiction at a low dosage that does not relieve the withdrawal craving.
Add to this the fact that the smoker continues to incur significant cost, with nothing to show for it in terms of withdrawal from nicotine dependency. Less apparent, the heavy marketing of such nicotine replacement therapy products has a similar, unconscious, conditioning effect to the promotion of cigarettes themselves - and you don’t want to be hooked on patches forever. At best this leaves the smoker confused.
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Tags: nicotine gum, nicotine patches, nicotine replacement therapy, NRT, stop smoking remedies