Chapter 22 Smoking and tobacco cessation

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Smoking and tobacco cessation: Nicotine replacement and

pharmacologic treatment

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Nicotine patches were used by 5 million Americans and had $1 billion in sales in

1992, the year that they were first marketed.

JAMA, May 26, 1993, p. 2615

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The 1997 market for smoking cessation products, after the nicotine patch was

approved for over the counter sale, is expected to be $500 million to $1 billion,

compared with about $250 million in 1996.

Wall Street Journal, June 25, 1997, p. B1

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The 21- or 22-milligram nicotine patches release about the amount of nicotine that a

smoker would get form 10 to 20 cigarettes a day, depending on the brand.

14-milligram patches are roughly equivalent to smoking 5 to 10 cigarettes a day.

San Francisco Chronicle, April 1, 1992, p. D3

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Three-month nicotine patch therapy, even when used with virtually no behavioral

treatment component, can produce one-year sustained abstinence rates of 11%.

Though modest, this figure was a solid five-fold increase over placebo patches.

Journal of Smoking-Related Disease 5:183, 1994 (supplement)

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"Transdermal nicotine is safe and easy to use, has very good compliance, and

increases quit rates by a factor of 2.5 even when smokers do not attend concurrent

behavior therapy... At 3 months after their quit day, 29% of subject who ever used the

patch reported not smoking currently... For these reasons, we believe state health

departments, Medicaid, and Medicare programs, and health maintenance

organizations should fully reimburse transdermal nicotine for poor smokers. It is ironic

that in many states the poor can receive free treatment for non-life-threatening

disorders such as otitis media, but can not receive free treatment for a dependence

that has a 40% chance of causing their death."

JAMA, July 19, 1995, p. 214 (John Hughes)

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Thursday, July 06, 2000

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