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.