Nicotine Patch

Description

Cigarette smoking is the leading cause of preventable death in the U.S. today. Each year, one out of every six deaths in the nation is attributable to this habit - a public health threat so severe that the Surgeon General set the ambitious goal of a smoke-free society by the year 2000.

As every smoker knows, quitting is no easy matter. Cigarettes and other tobacco products are both physically and psychologically addictive, principally because they contain a powerful drug - nicotine. Therefore, when a revolutionary new aid to quitting, such as the nicotine patch is developed, hopes are understandably high.

The patch itself contains a multi-layered gel or reservoir that includes nicotine as its active ingredient. Small amounts of nicotine are slowly absorbed through the skin and enter the blood, replacing the dose of nicotine the smoker would normally be inhaling.

Over a three-month period, the dose of nicotine is gradually reduced, so that by the end of the program, the user should no longer be physically dependent on nicotine. Available only by prescription, the transdermal nicotine patch should not be used without a doctor's supervision.

The patch is easier to use than nicotine gum and does not cause stomach distress. Nevertheless, it has a few side effects of its own. In one large study, half the patients who used the patch reported transient itching or burning at the site of application, and in 14 percent, the area under the patch became red at least once during the study.

To reduce the risk of skin irritation, patients should move the patch to a different site each day. It is waterproof and can be applied to any part of the body where neither hair nor perspiration will prevent it from adhering to the skin properly.

There are several brands of FDA-approved nicotine patches on the market. These include Habitrol, Nicoderm, and Pro Step. All three patches appear to be equally effective.

The patches are fairly expensive - typical pharmacy charges are about $3.50 per patch - and many patients who try them are still unable to quit smoking. As is often the case with a new treatment, patches generated high expectations when they were introduced but caused disappointment when the results fell somewhat short.

However, new data on large numbers of people offer convincing evidence that nicotine patches can help people stop smoking. These results also provide insight into who is most likely to benefit from this treatment.

Effectiveness of the Nictotine Patch

One study reported that smokers who used the transdermal patch, in conjunction with counseling, were able to stop smoking more easily than those who simply relied on counseling. It is argued that nicotine-containing products such as the transdermal patch and nicotine gum give smokers a running start to clear the second hurdle - breaking the psychological habit.

Persons who quit smoking tend to gain weight, perhaps 5 to 10 pounds. Despite some initial claims to the contrary, the nicotine patch does not prevent weight gain. Still, the health risks of a few extra pounds are minimal compared with the risks posed by continued smoking.

When people start the patch, they should be prescribed a dose sufficient to prevent nicotine withdrawal symptoms, such as irritability, awakening at night, difficulty concentrating, and hunger. And since relapse rates are so high in the first few weeks, quitters should seek all the counseling and psychological support they need during this critical early period.

Questions to Ask Your Doctor

Will the nicotine patch help me quit smoking?

Which patch brand do you recommend?

Do you advocate accompanying counseling and psychological support?

What are the side effects of the patch?

Will there be withdrawal symptoms? Is there a way to help in the withdrawal process?

How can skin irritation be avoided?

Is weight gain a possibility?