For stopping smoking, practice (plus lozenges) does not make perfect

We re always eager to hear the results of smoking cessation trials, hoping for some rare good news on this subject. But the latest trial of nicotine therapy has us baffled. In this nationwide randomized clinical trial just reported in the Archives of Internal Medicine, researchers studied the effect of nicotine lozenges on smokers who were in a practice quit attempt trial. The smokers were not committed to quitting and were not advised to do so. While smokers aided by the lozenges more successfully abstained over a 24-hour period than those given no lozenges, the six-month abstinence rates were essentially identical, about 15 percent.

While the authors conclude that the use of nicotine lozenges during the practice quit attempt, designed to increase motivation and coping skills, is a useful way to motivate smokers to quit, we d say that unfortunately the six-month abstinence rates speak for themselves.

Aside from confirming the low success rate of nicotine lozenges, says Dr. Ross, I see little value in this study. As ACSH's Dr. Gilbert Ross points out, smoking is responsible for about 443,000 deaths in the U.S. each year, and, at this point, with smoking rates declining only minimally over recent years, health officials need to change their approach. Smokeless tobacco has far greater efficacy rates in helping people to quit smoking, and electronic cigarettes look very promising, he notes. Unfortunately, the main objection to these methods is the belief that nicotine is hazardous. But this, of course, isn t true. It s the inhalation of combustion products of tobacco the smoke that s carcinogenic.

It s too bad, says Dr. Ross, that this study is getting attention as a supposed success story. Further attention to smokeless tobacco and e-cigarettes is what s really going to help smokers.