Smoking
Analyzing Milestones and Misses in Smoking Cessation
By University of Pittsburgh
Apr 26, 2006, 18:30

In the first study of its kind, University of Pittsburgh psychologist and professor Saul Shiffman has discovered that people who are trying to quit smoking by wearing the nicotine patch are less likely to spiral into a total relapse if they keep wearing the patch, even if they've "cheated" and smoked a cigarette.

Shiffman and his associates not only examined the treatment's final outcome-the question of whether the patch worked-but also measured treatment milestones, such as momentary lapses, to try to find out more about why and how a nicotine patch works. Smokers in the study were using either a high-dose NicoDerm CQ nicotine patch (35 mg, 2/3 stronger than the currently marketed 21 mg patches) or a placebo patch. Using hand-held computers as electronic diaries, the 324 participants recorded exactly when they were craving a cigarette and if and when they lapsed and smoked one. The resulting data showed that people who wore the active patch after lapsing were 4 to 6 times less likely to "cheat" again and again. The nicotine patch not only helped prevent slips, but also was more effective in preventing the slip from turning into a full relapse. Prior to this, people who slipped while trying to quit were considered "failures," and no treatment was considered effective in helping ward off relapse. And, Shiffman calls the notion that a person who smokes while wearing a patch is risking a heart attack a "myth."

The study also is significant because it analyzes mechanisms of action and could provide a better understanding of addiction treatment overall. It also offers insight on how different techniques could be effective in different phases of treatment. For people trying to quit smoking, the study has immediate implications: Use a patch. And, if you slip, stay with it.

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