The Nicotine Transdermal Patch: A Cautionary Note

Excerpt

To the Editors: The nicotine transdermal patch, the newest pharmacologic adjunct for smoking cessation, has recently been introduced in the United States. Two recent reviews of this product concluded that it is effective (1, 2). The reviewers raised concerns about its long-term effectiveness and the generalizability of results (1), and they pointed out the importance of concomitant behavioral modification (2). Based on our experience with nicotine gum, we would add an additional concern: its potential for misuse.

The results of early nicotine gum trials raised unrealistic expectations (3, 4). Nicotine replacement was often overprescribed or used without behavioral modification. Disappointing