Skip to main content

Advertisement

Log in

A naturalistic cohort study on effectiveness, safety and usage pattern of an over-the-counter nicotine patch

Cohort study on smoking cessation

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Introduction

Nicotine replacement therapies (NRT) are effective for smoking cessation. After having received over-the-counter (OTC) status in Germany, concerns grew about effectiveness, increased risks, especially of adverse cardiovascular reactions, and inappropriate use of NRT. Thus, a pharmacy-based cohort study was launched.

Objectives

To assess effectiveness, safety and appropriateness of use of an OTC nicotine patch (Nicotinell, Novartis Ltd.). Every customer who bought an OTC Nicotinell patch was eligible. All data were collected by self-administered questionnaires at weeks 2, 4, 8, 12 and 24 after inclusion. Six hundred and thirty-three customers were admitted, median duration of smoking was 19 years. Of the participants, 6% smoked up to 10 cigarettes per day, 43.6% between 11 and 20, 34.3% between 21 and 30, and 16.1% more than 30 cigarettes. Twenty-four weeks later, 351 participants replied: 28% (177 of 633) had quit smoking completely. Considering replies only the proportion of complete responders raised to 50.4%. There were no serious adverse events reported; 62.9% complied with the directions for use and did not use the patch for more than 3 months. About 45% smoked simultaneously with NRT. Pharmacy-based cohort studies are feasible. This study indicates that the nicotine patch is effective and safe in an OTC setting. There is still room to improve compliance with the directions for use.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Department of Health and Social Security (1999) Smoking kills—a white paper on tobacco. The Stationary Office, London

  2. Silagy C, Lancaster T, Stead L, Mant D, Fowler G (2001) Nicotine replacement therapy for smoking cessation (Cochrane Review). Cochrane Database Syst Rev 3:CD000146

    PubMed  Google Scholar 

  3. Lasagna L (1974) A plea for the "naturalistic" study of medicines. Eur J Clin Pharmacol 7:153–154

    CAS  PubMed  Google Scholar 

  4. Heatherton TF, Kozlowski LT, Frecker RC et al (1991) The Fagerström test for nicotine dependence: a revision of the Fagerström Tolerance Questionnaire. Br J Addiction 86:1119–1127

    CAS  Google Scholar 

  5. Sinclair HK, Bond CM, Hannaford PC (2001) Long term follow-up studies of users of nonprescription medicines purchased from community pharmacies. Drug Safety 24:929–935

    CAS  PubMed  Google Scholar 

  6. Orleans CT, Resch N, Noll E, et al (1994) Use of transdermal nicotine in a state-level prescription plan for the elderly: a first look at 'real world' patch users. JAMA 271:601–607

    Article  CAS  PubMed  Google Scholar 

  7. Shaw JP, Ferry DG, Damian PB et al (1998) Usage patterns of transdermal nicotine when purchased as a non-prescription medicine from pharmacy. Tob Control 7:161–167

    CAS  PubMed  Google Scholar 

  8. Hughes JR (2001) Commentaries on the effectiveness of over-the-counter nicotine replacement. Drugs Alcohol Rev 20:319–324

    Article  Google Scholar 

  9. Hays JT, Croghan IT, Schroeder DR et al (1999) Over-the-counter nicotine patch therapy for smoking cessation: results from randomized, double-blind, placebo-controlled, and open label trials. Am J Public Health 89:1701–1707

    CAS  PubMed  Google Scholar 

  10. Rumpf H-J, Meyer C, Hapke U, Dilling H, John U (1998) Stadien der Änderungsbereitschaft bei Rauchern in der Allgemeinbevölkerung. Gesundheitswesen 60:592–597

    CAS  PubMed  Google Scholar 

  11. Junge B, Nagel M (1999) Das Rauchverhalten in Deutschland. Gesundheitswesen 61:S121–S125

    PubMed  Google Scholar 

  12. Tonnesen P, Paoletti P, Gustavsson G et al (1999) Higher dosage nicotine patches increase one-year smoking cessation rates: results from the European CEASE trial. Collaborative European Anti-Smoking Evaluation. European Respiratory Society. Eur Respir J 13:238–246

    Article  CAS  PubMed  Google Scholar 

  13. Balfour D, Benowitz N, Fagerström K et al (2000) Diagnosis and treatment of nicotine dependence with emphasis on nicotine replacement therapy. a status report. Eur Heart J 21:438–445

    Article  CAS  PubMed  Google Scholar 

  14. West R, Hajek P, Foulds J, Nilsson F, May S, Meadows A (2000) A comparison of the abuse liability and dependence potential of nicotine patch, gum, spray and inhaler. Psychopharmacology 149:198–202

    Google Scholar 

  15. Gourlay SG, Forbes A, Marriner T et al (1999) Predictors and timing of adverse experiences during transdermal nicotine therapy. Drug Safety 20:545–555

    CAS  PubMed  Google Scholar 

  16. Joseph AM, Norman SM, Ferry LH et al (1996) The safety of transdermal nicotine as an aid to smoking cessation in patients with cardiac disease. N Engl J Med 335:1792–1799

    Article  CAS  PubMed  Google Scholar 

  17. Kimmel SE, Berlin JA, Miles C et al (2001) Risk of acute first myocardial infarction and use of nicotine patches in a general population. J Am Coll Cardiol 37:1297–1302

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Joerg Hasford.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hasford, J., Fagerstrom, K.O. & Haustein, KO. A naturalistic cohort study on effectiveness, safety and usage pattern of an over-the-counter nicotine patch. Eur J Clin Pharmacol 59, 443–447 (2003). https://doi.org/10.1007/s00228-003-0629-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00228-003-0629-8

Keywords

Navigation