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When California smokers use nicotine replacement therapy, most are trying to quit smoking
  1. W K Al-Delaimy,
  2. E A Gilpin,
  3. J P Pierce
  1. Cancer Prevention and Control, University of California, San Diego, Cancer Center, La Jolla, California, USA
  1. Correspondence to:
 W K Al-Delaimy

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Extensive literature exists about nicotine replacement therapy (NRT) efficacy in randomised clinical trials of smoking cessation,1 yet population data do not show sustained effectiveness after NRT became available over the counter in the USA.2,3 Some claim that product cost is the main obstacle for its lack of population effectiveness.4 A large population based natural experiment is underway in New York that will test this hypothesis. Others suggest that smokers may be using NRT for reasons other than quitting, such as harm reduction or to mitigate withdrawal symptoms when they are unable to smoke.5

We present data from the 2002 California …

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