Use of nicotine replacement after a smoking lapse

Abstract

Introduction: Current labeling for nicotine replacement therapy (NRT) in the United States and many countries discourages continued use of NRT after a lapse; however, recent studies and consensus statements conclude that continuing NRT postlapse substantially increases long-term abstinence. What percent of clinicians recommend continuation of NRT upon a lapse and what percent of NRT users continue NRT postlapse are unclear.

Methods: The author queried 24 treatment smoking cessation programs or providers, treatment protocols, directors of quitlines and state programs, published treatment texts, and self-help manuals, books, and Internet sites. The author also recruited 101 current smokers who had attempted to stop smoking in the last 3 months and lapsed while using NRT to complete a survey via an E-mail invitation to an Internet consumer database (www.zoomerang.com).

Results: Most programs and providers (67%) did not discuss use of NRT postlapse, and only 8% recommended continuing NRT postlapse. Among recent quitters using NRT, about one fourth (27%) stopped NRT on the day of the lapse, and one fourth (25%) used NRT for only 1 or 2 days postlapse. Most (73%) reported that use of NRT postlapse was helpful.

Discussion: In summary, advice to use NRT postlapse and actual use of NRT for several days postlapse are uncommon.