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“Patches and gums stabilize nicotine levels for a longer time, which can help the smoker reduce the craving for cigarettes and eventually quit,” says Emmanuel Pothos. Photo: iStock
Ask The Professor
Are nicotine patches or gums any more effective in helping smokers to quit than just going cold turkey?
Emmanuel Pothos, assistant professor of pharmacology and experimental therapeutics at the School of Medicine, takes on this month’s question:
Nicotine patches and nicotine gums are a more effective method to try to quit smoking than the cold-turkey approach because they elevate nicotine blood levels for a much longer time than cigarettes and therefore reduce the craving for smoking tobacco. With a patch or gum, nicotine levels in the blood rise slowly and stay high for more than two hours, while a cigarette would “spike” nicotine levels within 20 to 30 minutes and then lead to a quick reduction, which can be responsible for inducing craving and more smoking. The patch is relatively more effective than the gum in stabilizing blood nicotine levels and may make it easier to eventually quit.
Patches and gums don’t make smokers addicted to nicotine because they already are addicted to it through tobacco. Patches and gums stabilize nicotine levels for a longer time, which can help the smoker reduce the craving for cigarettes and eventually quit. Of course, there is no reason for a non-smoker to try nicotine patches or gums.
Beyond nicotine patches and gums, it should be noted that bupropion (with the brand name Zyban) and varenicline (Chantix) have also recently shown substantial improvements in smoking cessation rates, although not without side effects in some patients. Those with depression and psychiatric problems in particular should probably avoid these drugs, as adverse effects on their behavior may occur. Close medical supervision by a physician before, during and after treatment with these drugs is necessary.
Finally, no pharmacological treatment can work alone. Intervention by a physician offering routine advice to quit as well as counseling during the different stages of smoking cessation—from contemplating quitting to committing to do so—and follow-up care are essential.
In addition, there is no evidence that hypnosis, acupuncture, anti-anxiety drugs or antidepressants using selective serotonin reuptake inhibitors (SSRIs) are effective in smoking cessation.
Have a question for “Ask the Professor”? Email taylor.mcneil@tufts.edu.
