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- HEALTH, Page 52A Patch of Hope for Smokers
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- Doctors will soon begin prescribing a new nicotine device that
- can help people stay off cigarettes for good
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- Smoking is complex. Just ask the 50 million Americans who
- continue to do it despite abundant evidence that as a diversion
- its safety ranks somewhere between bungee jumping and Russian
- roulette. For the past decade, addiction researchers have
- struggled to sort through the tangle of biological urges and
- psychological cravings that stir people to light up, in an
- attempt to develop better ways to kick the habit. That effort
- is finally beginning to bear fruit.
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- Over the next few months, four drug companies will
- introduce similar versions of the transdermal nicotine patch,
- a palm-size circular envelope that, when applied to the upper
- arm or back every 24 hours, releases a steady stream of nicotine
- into the blood. A study in last week's Journal of the American
- Medical Association found that the patch, when administered with
- proper counseling, doubled the odds that smokers will
- successfully quit over a six-month period. "It's a major
- breakthrough in medicine by any measure. It could save thousands
- of lives," said Dr. Jack Henningfield, chief of clinical
- pharmacology at the National Institute on Drug Abuse.
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- The idea of using pure nicotine to help smokers stop was
- first tried in the mid-1980s with the nicotine-laced chewing gum
- Nicorette. The drug provides relief from the symptoms of
- physical withdrawal -- anxiety, difficulty concentrating -- so
- that people can focus on the behavioral side of their addiction.
- But Nicorette has proved disappointing, largely because heavy
- smokers have trouble getting a sufficient dose to match their
- craving. In addition, the gum can cause soreness in the mouth
- and upset stomach. Patches overcome these shortcomings by
- steadily pumping the drug directly into the bloodstream. After
- a month of daily use, ex-smokers wean themselves from the
- nicotine by applying successively smaller patches.
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- But experts caution that the device will work only when
- combined with counseling, which should include advice on setting
- a "quit date" and on coping with the urges that will persist
- even with the patch in place. Unfortunately, physicians have a
- poor record in this regard. Less than half of 2,700 smokers
- surveyed for a study in last week's Journal said their doctors
- had ever advised them to kick the habit or even to cut down.
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- Moreover, scientists are only beginning to understand the
- factors that drive cigarette addiction. A smoker can take a
- million puffs during a lifetime, and each of those becomes
- indelibly linked with a particular activity -- drinking coffee,
- talking on the phone, driving. In his recent book, Smoking: The
- Artificial Passion, David Krogh writes, "Addiction and
- attachment, pharmacology and behavior, personality, culture and
- genetics all chase each other around like a cat after its own
- tail when we start to consider the issue of why people smoke."
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- Inevitably, the new patch will not be able to cure most
- smokers. According to last week's report, 26% of those wearing
- the device actually succeeded in abstaining for six months, as
- opposed to 12% of those using a placebo patch. Still, for
- smokers the choice seems clear: a 1 in 4 chance of quitting
- successfully, or the same odds of dying of a tobacco-related
- disease if they do not.
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- By Andrew Purvis
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