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P.S. On Nicotine Gum And Patches: This Study ‘Shakes Up The Field’

You know the old joke: “I’m great at quitting smoking: I’ve done it more than a dozen times!” That’s what I thought of when I saw the Harvard/UMass study earlier this week questioning the hundreds of millions of dollars spent on nicotine gum, patches and other forms of “nicotine replacement therapy.”

I caught up a bit late with Boston University School of Public Health professor Michael Siegel, a leading tobacco control researcher whom I’ve seen quoted in the Boston Globe dozens of  times. So mea culpa for tardiness, but I still want to put his considered perspective on the record. Some of the coverage made it sound like the new study is just the latest salvo in a long debate over whether nicotine replacement therapy is worthwhile, but my impression from Prof. Siegel — who, granted, has long been a skeptic of nicotine replacement — is that this may be more of a game-changer.

His take on the study, lightly edited:

Strictly speaking, what this study looked at was smoking relapse. These were smokers who had quit, so from a strict perspective, this study can only conclude that nicotine replacement was not effective in helping prevent relapse.

‘In the field, generally there’s a dogma that nicotine replacement therapy is the state of the art.’

However, when you think about it, the smoking cessation process almost always involves relapse, so in a sense, you can infer from the study that nicotine replacement is not effective for quitting because quitting involves being sustained. If you took a bunch of quitters at a given time and you wanted to predict whether they were going to sustain their quitting, those on nicotine replacement therapy were no more likely to sustain their quitting. I do think that this study does provide evidence that in general, nicotine replacement therapy is not effective for quitting.

Is this new, did we know this? Yes and no. Continue reading