NHS maybe wasting millions on nicotine patches

Oh surprise, surprise  … Nicotine Replacement Therapy (NRT) – whether patches, gum, sprays or inhalers – has been shown to be relatively ineffective at helping smokers quit and remain non-smokers.  Raising important questions as to whether millions of pounds of NHS funds are being wasted.

New evidence raising these doubts over NRT and of course the  pharmaceutical industry's massive campaign to promote sales,  follows research which found smokers who quit through NRT were just as likely to start again as those who stopped through will power alone.

The ten year study, conducted by Harvard School of Public Health and the University of Massachusetts,  discovered that smokers who quit through NRT were just as likely to start again as those who stopped through will power alone.

The new paper – “A prospective cohort study challenging the effectiveness of population-based medical intervention for smoking cessation”   by Hillel R Alpert, Gregory N Connolly, Lois Biener  –  examined  the  “effectiveness of nicotine replacement therapies   either with or without professional counselling, and provide evidence needed to better inform healthcare coverage decisions.

Starting in the 2000, the US researchers followed a representative sample of 1,916 adults which included 787 who had recently quit smoking.

Each participant was interviewed three times, about once every two years during the 2000s, asked about their use of gum, patches and other such products, their periods of not smoking and their relapses.

At each stage, about one-third of those trying to quit had relapsed and the use of replacement products made no difference, whether they were taken for the recommended two-month period or with the guidance of a counsellor.

Significantly the study showed the relapse rate was just as high among those using NRT as though who went “cold turkey.”

Who would have thought it eh?  Well this writer for a start. And probably also every hypnotherapist who has successfully helped people to stop smoking with   clients/patients who had previously tried patches, gums etc.

Time and again smokers who want to quit the habit have come to my practice room reporting how they had tried NRT but had failed to quit.

Fairly recently one such client was a general practitioner who said he regularly prescribed nicotine replacement for his patients but knew that for most patients it did not work.

The US findings – published in the online edition of Tobacco Control   – showed much the same outcomes for both heavy and light smokers irrespective of Is whether or not NRT was accompanied by professional cessation counselling. 

It is worth noting that in the United Kingdom the Department of Health generally claims counselling doubles the success rate.

However close examination of the UK figures shows that the failure rate for NRT is over 90 per cent

The study’s lead author, Hillel Alpert from Harvard School of Public Health’s Center for Global Tobacco Control, commented: “This study shows that using NRT is no more effective in helping people stop smoking cigarettes in the long-term than trying to quit on one's own."

"Even though other well-controlled studies have shown that nicotine replacement therapy can be effective, our study looked at real-world use over the long-term. And in the real world, cigarettes are simply a very powerful addiction. And NRT is apparently not an effective replacement for that addiction."

About ten years ago researchers at the University of California, San Diego conducted a large scale survey of NRT  – “Impact of Over-the-Counter Sales on Effectiveness of Pharmaceutical Aids for Smoking Cessation”   by John P Pierce, PhD; Elizabeth A Gilbin   – which also concluded that “since becoming available over the counter, NRT appears no longer effective in increasing long-term successful cessation in California smokers.”

It's Good to Talk

Dear Kate,

My wife has told me that she has been having an affaire; we have been together ten years and married for three. 

We met on our first day at university in the UK and have been together ever since, moving to Ibiza five years ago. I knew we were in trouble but never in my wildest dreams thought that this would happen. 

I have asked her to go to counselling but she refuses saying her mind is made up that we are over. I am totally gutted, I thought we would be together forever and we had been talking about having children. 

The additional pressure is that neither of us have  found anywhere to stay and it is so expensive here that it may take a while and in the mean time we are stuck living in the same house which is making me feel even worse especially when she “goes out”.

Any pointers you have would be really appreciated 

Thank you

Bob (not my real name)

Dear Bob

Thank you for your e-mail and sorry to hear that Christmas and New Year have been so difficult for you. 

It sounds as if you have no hope of reconciliation with your wife and are going through the motions of having to accept the situation that you now find yourself in. This can be very difficult and often brings up uncomfortable emotions, disbelieve, acceptance and anger to name a few. 

These are all completely to be expected and it is important to acknowledge them and spend a little time on reflecting how they are influencing your every day life and behaviours towards yourself and others. They will pass in time so be particularly kind to yourself during these early stages of the break up.

On a more practical note, is there no way your wife can move out even for a short period of time to give you some space to process what has gone on. I wonder why you haven’t insisted on this given it is her who has created this situation; does she not have some responsibility to create a physical situation that is easiest for you both? 

I wonder whether there is something more that is stopping you from asking her to leave? Do you have some hope still that things are redeemable?  Or maybe one of you moving out signifies a much more real and physical end to the marriage. 

Whatever it is, it might be beneficial to ask yourself some questions about how to move forward in a way that is best for you.

It does seem like you were / are fully committed to this marriage having been together for 10 years and to have started talking about children must have been a big step for both of you.

There are lots of changes that happen in the first ten years after leaving university in your 20’s and the both of you have grown up together and maybe part of that growing up has brought changes in your views on the future which could never have been foreseen.

In time you will come to terms with the new future that is now in front of you and one day it will feel exciting and challenging to be able to make those choices but for now take care and focus on you and how best you can manage both the emotional and physical implications of your situation.

All the best

Kate