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Free NHS nicotine patches 'don't help smokers quit'


Offering smokers free nicotine patches or intensive counselling via an NHS helpline does nothing to help them quit, according to a government-funded study.

Giving people extra packages of support would have no effect on the number of smokers who stop, a trial of different interventions showed.

It follows data released last August which showed that while more people in England are trying to quit with NHS help, success rates have fallen.

The new study, funded by the Department of Health and the UK Centre for Tobacco Control Studies, is published online in the British Medical Journal (BMJ).

Researchers from the University of Nottingham, which is home to the Centre for Tobacco Control Studies, split 2,600 smokers into four groups.

The first received standard support in the form of NHS Stop Smoking Services advice, letters, emails, text messages and access to a helpline.

The second group received the same support but were also offered free nicotine replacement therapy (NRT) in the form of a 21-day supply of patches.

The third group received “proactive support” in the form of standard support plus extra counselling sessions and messages from helpline staff.

The fourth group received the same proactive support as the third group but with added free nicotine patches.

Data was collected one month and six months after the participants had agreed to quit.

The result showed that, overall, 19% of the 58% of people who could be contacted at six months said they had managed not to smoke, and this was backed up with breath tests.

Those whom the researchers were not able to contact were assumed to still be smoking.

The study found no significant difference in success rates between those people offered different types of supportive counselling, or between those given nicotine replacement therapy.

Some 18.2% of those given proactive support had quit compared with 19.6% of those who did not receive this support.

Overall, 17.7% of smokers offered the patches stopped smoking, compared to 20.1% of those not offered them.

Even one month after setting a quit date, no significant differences were found between the groups.

The authors concluded that offering people extra telephone counselling and free NRT through a helpline cannot be recommended.






Readers' comments (13)

  • Yes But

    Surprising how much treatment isn't backed up by much evidence of its effectiveness, isn't it ?

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  • tinkerbell

    As someone who has been on nicotine replacement therapies for over 20 years and still smokes but now hooked on both, what a buzz! (for which i have always paid.

    Nobody, in my drug crazed opinion, will give up anything unless they truly want to.

    But i can see how removing these free therapies will save the NHS some more money, so maybe that's what's on the agenda, and if everyone gave up smoking and drinking where would they get the tax revenue from to replace it?

    I am smoking for Britain, except when at work of course and then i use my replacement therapy. Who needs a skateboard to whizz round the ward, when i can pass myself on the way back with a racing pulse of 109. I must remember to chew more slowly. I now have a nicotine dependency that far exceeds any i had before i started on the patches, gum yada, yada.

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  • tinkerbell

    and when the assistant at boots chemist asks me 'have you used these before?' we both smile at each other knowingly because she has mostly served me over these many years.

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  • Juggling Dog

    Nobody, in my drug crazed opinion, will give up anything unless they truly want to.

    I agree, and that is also the reason why dieting does not work: you need to permanently change the way you eat, to diet successfully.

    Bet you are looking forward to nudging patients into becoming non-smokers ?

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  • tinkerbell

    Juggling Dog | 23-Mar-2012 2:35 pm

    the poor old folk where i work don't get the luxury of choice. They are mostly made to quit the day after they are admitted, cold turkey, like it or not. No smoking allowed anywhere.

    I know smoking is a disgusting habit but where's their choice. Talk about ageist. Some of these folk fought in the 2nd world war for our democracy.

    'No decision about me, without me' and all that tosh.

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  • tinkerbell

    and just to add whilst i remember. One of our old chaps suffered with severe parkinsons. There was a best interests meeting held for him. In this meeting he was told by a social worker that he should not be allowed to go home because

    'it's very difficult for us to agree you be discharged when we see you struggling this way'.

    He replied' I can assure you it is much harder for me to be this way than it is for you to see mestruggling this way and i want to go home'.

    He was discharged and i thought 'well said, good on you mate'. Someone less spirited though would have been kept there who couldn't speak up for themselves and i don't think even a patient advocate could have come up with that answer.

    Obviously this was a few years ago as in the current climate they probably couldn't wait to get him out the door into the community.

    I know we are all trying to do the best for our patients, but sometimes it really does border on total interference.

    Smoking is still bad though and i don't condone it at all even though i smoke, but we would if necessary buy some fags for one of our old folks. Just because they may have forgotten the word for a fag doesn't mean that isn't what they are asking for. So we try to wean them off slowly as the GP is reluctant to provide patches from his budget.

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  • According to a recent newspaper report, there is a research project that is trying to find out whether or not paying pregnant women to stop smoking will help quit rates.

    What will it take to stop people from smoking?!

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  • it doesn't seem right to stop people with dementia or other patients without mental capacity from smoking if that is what they have done all their lives and what they enjoy. it sounds like one organisation or person imposing their own will on another and depriving them of their rights to freedom of choice.

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  • The article doesn't mention people with dementia. It's just more research proving that there are no really effective methods for helping people to stop quitting a habit that has disasterous consequences for their health, and costs us billions of pounds in picking up the health bill.

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  • michael stone

    Tinkerbell, your comments about the patient who decided to go home, and your reference to No Decision About Me Without Me, raise an issue which vexes me.

    No Decision About Me Without Me has now lost prominence to Shared Decision-Making, but it all misses the point !

    Adults who are not (already) known to be mentally incapable, can make their own decisions – that patient pretty clearly was of sound mind, and adults make their own risk-benefit judgements – if he considered that the benefits to him of being at home outweighed the risks, then he can go home ! You couldn’t stop him from going home, without assaulting him – that is why clinicians need to get consent for treatment, because otherwise it amounts to assault. There is a legal concept that the decision lacks validity if the person has not be adequately informed, which is why the clinical rule is usually called Informed Consent – but you can’t tell people what decisions they should make, just because they are old ! There is no legal concept that because an adult makes a decision you don’t like, it wasn’t his decision to make !

    If people are demented, it is a VERY DIFFERENT matter – but the law and ethics for dementia, especially long-term dementia, are hideously complicated, not fully developed and probably not 100% understood by anyone.

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