It’s been found to be OK to use such therapies and smoke at the same time, so that a smoker can quit gradually.
“There’s a kind of mythology that if you smoke while using one of these nicotine-replacement products, that’s toxic,” says Saul Shiffman, a psychologist at the University of Pittsburgh. During the 1990s, there were false rumors that simultaneously smoking and using a nicotine patch could trigger a heart attack.
In a review published in 2008 in the journal Addiction, Shiffman analyzed four previous studies, concluding that a smoker’s chances of quitting are doubled if he starts using a nicotine patch two weeks before his quit date.
The success of the therapy may depend on how the patch satisfies nicotine craving and thus breaks the link between smoking and pleasure, according to Jed Rose, director of the Duke Center for Nicotine and Smoking Cessation Research in Durham, N.C. “Cigarettes become less enjoyable when smoking on the patch, just as eating when you’re not hungry is not as rewarding as when you are,” Rose said.
Another recent study by Shiffman, published recently in the American Journal of Preventive Medicine, showed that use of nicotine gum before quitting was also effective in smoking cessation. Subjects on nicotine gum were three times more likely to quit and still be smokeless after six months.
The U.S. Department of Health and Human Services in 2008 recommended the mixing of nicotine-replacement therapies, based on five studies that found using the patch and gum together (versus the patch alone) almost doubles one’s chances of quitting.
“I think no one should use one nicotine replacement anymore,” says John Hughes, a psychiatrist at the University of Vermont in Burlington.