U professor lauds nicotine patch

by Brian Vats-Fournier

University psychiatry professor Dorothy Hatsukami thinks that last week’s Food and Drug Administration approval of Nicoderm nicotine patches, the second brand to receive approval for over-the-counter distribution, is a step in the right direction.
Many of America’s 45 million smokers want to quit, Hatsukami said. Without using aids like the patch as nicotine replacements, some of them may find it very difficult to do so, she said.
Of special concern to Hatsukami are recovering alcoholics, many of whom continue to smoke heavily even while abstaining from alcohol. “Recovering alcoholics are dying more often from smoking-related diseases than from alcohol-related diseases,” she said.
These findings prompted Hatsukami to initiate two studies on recovering alcoholics who smoke. The first study looks at whether treatment appropriate for the general smoking population is also appropriate for recovering alcoholics. The central question is whether recovering alcoholics who smoke need more intervention than the average smoker.
The second study, done in conjunction with Hazelden treatment centers, works to fight procrastination involved when recovering alcoholics decide to quit smoking.
“We are trying to expedite their commitment to quitting,” Hatsukami said. This study will encourage recovering alcoholics who intend to quit to do so sooner and provide techniques and strategies to help them when they do, she said.
Hatsukami’s research stems from the findings of a recent study by Dr. Richard D. Hurt from the Mayo Clinic in Rochester. Hurt’s report was published in the April 10 issue of “JAMA: the Journal of the American Medical Association.”
The report states it intends “to heighten awareness of the effect of nicotine dependence on the outcomes of treatment programs for alcohol and other drug dependence.” It describes the need for nicotine-dependence treatment for recovering alcoholics as “imperative.”
Hurt’s findings show that, within a 20-year follow-up period, more than 50 percent of patient deaths were the result of tobacco-related causes while only about 34 percent were alcohol-related. Moreover, the overall mortality rate was higher than expected, implying that recovering alcoholics smoke more heavily than the average smoker.
Regarding FDA approval of the nicotine patch, Hatsukami said two issues remain to be resolved: approval for release to pregnant women and adolescents. Despite massive efforts to prevent both of these populations from lighting up, many pregnant women still smoke. And adolescents begin to smoke at a rate of 3,000 new smokers a day, Hatsukami said.
Studies show the nicotine patch doubles a smoker’s chances of quitting smoking.
“The two-to-one success ratio with minimal intervention and with intensive intervention remains the same,” Hatsukami said.
Nicotine-replacement products include audio tapes and brochures to provide some encouragement and tools to help users during the struggle to quit. The FDA’s Internet bulletin board reports that, among users of the 8- to 10-week Nicoderm program who use the support materials, 19 percent quit for good within one month. “Most smokers have to try to quit several times before they stop,” said FDA press officer Ivy Fleischer Kupec.
The Nicoderm patch may not be available yet in all pharmacies, but its competitor, Nicotrol, which was the first to receive FDA approval, is selling at area pharmacies for about $30, including a start-up kit.