Nicotine Patches

  I've been smoking for over 20 years now and I'd really like to quit. How effective are these nicotine patches? TIA!

[HVM-MD-SA]

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The use of Nicotine Replacement Therapies (NRT), by means of patches, gum, nasal spray or inhaler is currently recommended by large reputable medical task forces for ALL smokers attempting to quit.  Overall, only 5% of smokers are able to quit per year, despite the fact that most want to quit and many (perhaps as many as half) attempt to quit each year.  Smokers who attend smoking cessation groups (such as Freedom from Smoking, sponsored by the American Lung Association) have double the success rate (10%) of people trying to quit on their own.  The combination of NRT with group counseling doubles the quit rate yet again, up to 20%.  I am a strong advocate of NRT and believe in using it aggressively.  I tell my patients that nicotine is what hooks you, but it isn't the bad guy.  The bad guy is the smoke which contains carcinogens, carbon monoxide, tars and other toxins.
I view smoking cessation as a 2 step process.  The first step is to end the smoking without ending the dependence on nicotine.  When the ex-smoker who is receiving NRT feels good and ready (and, not before) to take the next step, then the dependence on nicotine can be addressed by a gradual weaning process.  If the weaning leads to heightened cravings and relapses, I would rather see longer term treatment with nicotine than a resumption of daily smoking.
The public and many healthcare professionals tend to underutilize nicotine replacement, and this is one of the reasons why the average smoker who eventually quits ends up succeeding only after an average of 11 failed quit attempts over a period of 18 years of wanting to quit.  So it pays to get involved in a sophisticated smoking cessation program which combines educational and counseling techniques with liberal use of NRT and other medication strategies (like bupropion).
Please take a look at the SMOKING section of my Ask DrSteve web site (URL below) along with the extensive Archive of Questions and Answers on tobacco on that site.
And, good luck!
Steve Adelman, M.D. (a.k.a., DrSteve)

Keywords:  smoking cessation, nicotine replacement

Ask DrSteve:  The Real Story About Smoking, Drinking & Getting High