Smoking cessation: a clinical study of the transdermal nicotine patch

Although cigarette smoking is a declining trend in the United States, the amount of cigarettes consumed by the American public is the same today as in 1964. The role of cigarette smoking in many disease processes is publicly well known, and smoking cessation has been proved to reduce risk for some diseases, but the various methods of cessation are often met with a high rate of treatment failure or relapse. In this study, the short-term efficacy of nicotine-replacement therapy by way of the transdermal patch system was evaluated in 110 patients in a family practice setting. Patches were tapered from 21 mg of nicotine to 14 mg to 7 mg, each for 30 days. Subjects wore one patch for every 24 hours and were instructed not to smoke. Telephone follow-up was used at 2 to 3 weeks to check smoking status and inquire for side effects, and further follow-up of those who had completed the 3-month program was initiated 6 months after the program began. Nineteen patients never filled the prescription, and six were lost to follow-up. Of the 85 who finished the program, 35% were still not smoking at 6 months after the study began. The other 65% had relapsed. Side effects were mild and were mainly related to skin irritation at the patch site and abnormal dreams. Combinations of this cessation method with physician counseling and other behavioral methods should improve the success rate of this encouraging treatment.