How long is too long to wear nicotine patches?

Adam’s Journal

My girlfriend gave up cigarettes almost three months ago, and I couldn’t be prouder of her.

Heidi had been smoking for a quarter-century when she decided to kick the habit. Like many quitters, she’s been using nicotine-replacement therapy—in her case, a nicotine patch—to help quell the urge to smoke. And it’s proven quite successful.

But after almost 90 days, I’ve begun to wonder: When is it time to give up the patch?


Dr. Prescott Prescribes

Bravo to Heidi! By choosing to lose the butts, she’s taken the single most dramatic step a person can to improve her chances of living a longer, disease-free life. Yes, better than eating right, exercising or controlling one’s weight. Healthy living choices don’t come any bigger than quitting smoking.

The tar in cigarettes increases a smoker’s risk of lung cancer, emphysema and bronchial disorders. The carbon monoxide in smoke multiplies the chance of heart disease. And nicotine is the chemical in cigarettes that plays the most powerful role in getting—and keeping—people hooked on smoking.

While nicotine deservedly has a bad rap, it’s important to separate the addiction issue from questions about its effects on health. Studies have not found any evidence that the chemical raises a person’s risk of developing cancer. It can elevate heart rate, constrict blood vessels and raise blood pressure, so it is possible that it could contribute to higher rates of cardiovascular disease.

Currently, the Food and Drug Administration recommends that people use nicotine-replacement therapies like the patch or nicotine chewing gum for no longer than 12 weeks. But in light of the huge medical benefits of giving up smoking and dearth of evidence regarding the dangers of long-term use of nicotine, the FDA is now considering whether to lengthen that recommendation substantially—or even eliminate it altogether.

Like other addictive substances, nicotine rewires the brain’s reward system, training users to associate intake with pleasure. Sudden withdrawal can bring on intense cravings, nervousness, irritability and insomnia. Doses of nicotine can reduce the physical symptoms of withdrawal and facilitate the quitting process.

Researchers might one day find that long-term nicotine use carries some health risks. But even so, such potential perils are dwarfed by those of smoking, which more than doubles the chances for stroke and coronary heart disease and increases incidence of lung cancer and chronic obstructive pulmonary disease by a factor of 12.

So how long would I recommend Heidi keep using patches? Just as long as she needs them to stay smoke-free.