Mar. 3--With nicotine substitutes, effective delivery is paramount.
Some smokers chew nicotine gum in an effort to quit, but instead of parking a slightly masticated piece between cheek and gum, they chomp the little squares like a wad of Bazooka. This sends most of the nicotine directly to the stomach, which doesn't want it.
"If you chew it like regular gum, it doesn't work and it makes you sick," says Sally Lerman, smoking-cessation counselor at St. Francis Hospital and Medical Center.
Others get the urge to smoke while wearing a nicotine patch, and since they've heard the false story that smoking while using the patch will cause a heart attack, they tear off the patch and light up and they're back to smoking, Lerman said.
The lesson is that if you're trying to quit, whether using an over-the-counter method or a prescribed medication, follow the directions and your chance of success will increase.
But following directions with e-cigarettes may be moot. Lerman says she doesn't have any e-cigarette stories because none of her clients has mentioned that method of trying to quit. She also noted that a recent study at Virginia Commonwealth University found that e-cigarettes offer poor delivery of the drug smokers crave.E-cigarettes vaporize liquid containing nicotine. They are marketed as a safe alternative to real cigarettes because the user isn't getting the tar and other nasty stuff that comes from tobacco smoke. But the Federal Drug Administration has concerns about chemicals in e-cig cartridges, and the recent Virginia study says that besides possible health dangers, the battery-powered butts deal a weak dose of nicotine.
"At the least, consumers should be aware that, unlike several as a safe alternative to real cigarettes [e.g., gum, patch], these putative drug delivery systems do not deliver nicotine effectively after acute administration," according to the study published in the most recent issue of the Tobacco Control journal ( www.tobaccocontrol.bmj.com).
So which stop-smoking methods are most effective?
--Chantix, a prescribed medication that blocks nicotine receptors in the brain, has the highest success rate at 44 percent, Lerman said. Those who use Chantix and receive counseling can boost their chances of success by up to 10 percent, she said.
-- Nicotine inhalers, another doctor-prescribed method, have about a 22 percent success rate, compared with 8 percent for a placebo.
-- Zyban, a prescribed medication, initially was developed as an anti-depressant (Wellbutrin). For smoking cessation, it has about a 30 percent success rate.
-- Nicotine gum, about 23 percent.
-- The patch, 17 percent.
Lerman says she begins her individual counseling sessions by going over a smoker's history, including quitting methods they've tried. For a six-week counseling program [one meeting a week], the cost is $275. Often the sessions are not covered by insurance, Lerman said. St. Francis also offers smoking cessation through hypnosis. The cost is $45 for the single session. For more information on the hospital's smoking cessation programs, call 877-783-7262.
For information on Hartford Hospital's programs, call 860-545-3127. For programs at the Hospital of Central Connecticut, which has campuses in New Britain and Southington, call 860-224-5433.
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