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Wearing the nicotine patch before quitting increases success, study says

July 9, 2009 |  2:52 pm

Smokers who wear a nicotine patch for two weeks before they quit smoking are twice as likely to kick the habit as those who puton the patch on the day they quit, finds a new study, published online in the journal Nicotine & Tobacco Research.

Smokers, and the physicians who advise them, have always been wary of suggesting the use of patch and cigarettes together for fear that the two-fisted approach would cause nicotine overdoses. And the labels of nicotine patches reflect that concern, warning would-be quitters not to use both at once.

But researchers at Duke University's Center for Nicotine and Smoking Cessation Research found that smokers who wore the smoking-cessation aid before they smoked were more likely to decrease the number of cigarettes they smoked in the two-week period before their official quit date. That's probably because the patch was satisfying some of their desire for nicotine, they surmised. When the time came to quit, it would seem that some had already dialed down their need to light up and puff.

In all, 22% of those who wore the patch for two weeks before quitting abstained continuously from cigarettes for 10 weeks. Only 11% of those who wore a fake patch -- the placebo -- abstained for that long.

One interesting parallel: The smoking-cessation drug Chantix is also to be started two weeks before a person's quit date. But Chantix is thought to suppress the urge to smoke not by replacing cigarettes' nicotine, but by blocking the brain's reward-seeking pathways, thus blunting the craving to smoke and the pleasure in doing so. 

Quitting is hard; and it's probably particularly hardfor the same reason that these two pre-quitting treatments probably help: because in addition to a smoker's physical need for nicotine, there is also the relaxing, pleasurable, familiar routine of breaking for a cigarette, staring into the cloud of blue smoke you've created and, for a brief spell, just floating in the sensation of relief. If that hypnotic spell can be eased -- or even broken -- before their quit date, maybe quitters will have one big battle, not two, to fight.

By the way, the FDA recently ordered warnings on Chantix cautioning those who take it to look out for signs of odd behavior or thinking: unusual aggression, irritability, sadness or suicidal behavior. Nicotine patches, so far, have been free of such concerns.

Finally, a disclosure by the Duke study's lead author, Jed Rose: Rose is one of the inventors of the nicotine patch, and has received royalties in the past on their sales. Also, the research was conducted under a grant from the tobacco giant Phillip Morris USA. Don't say we didn't tell you.

-- Melissa Healy 

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