Review of nicotine replacement therapy in helping people to stop smoking

Abstract

Nicotine replacement therapy is probably the most effective of the many methods available to help people to stop smoking (Law & Tang, 1995). Four major forms of nicotine preparations are now available: chewing-gum, patch, inhaler and nasal spray. Chewing-gum and patch have been the most extensively studied in randomized controlled trials, but the four preparations probably have very similar effectiveness: 10–15% of people give up smoking as a result of the treatment (Tang et al., 1994). The effectiveness is highly dependent on the provision of instructions for use and the choice of smokers. Nicotine replacement therapy is also recommend for patients with coronary heart disease and pregnant women since the benefits of treatment well outweigh any harm it may induce. We review the evidence from randomized controlled trials and systematic reviews, raise some issues with regard to the use of nicotine replacement therapy and point out potential ways of increasing the benefit—harm ratio of this therapy.