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Nicotine patch use in the general population: results from the 1993 California Tobacco Survey.

BACKGROUND
Evidence from controlled clinical trials indicates that use of a transdermal nicotine patch improves abstinence rates up to a year after initial smoking cessation. Whether these results can be generalized to the general population has not been extensively investigated.


PURPOSE
We sought to determine what characteristics of smokers trying to quit are associated with nicotine patch use in the general population and whether there is evidence that patch use promotes successful smoking cessation.


METHODS
As part of the 1993 California Tobacco Survey, 3281 respondents who had attempted to quit smoking cigarettes within the last year were asked whether they had used a prescribed medication to help them quit smoking and, if so, what type of medication it was. They were also asked whether they used other assistance.


RESULTS
Compared with nonusers, patch users (nearly 11% of quitters) were more likely to be female, white or Asian, middle-aged, and to smoke more heavily. Many people relapsed to smoking while they were still using a patch. However, no evidence suggested that the patch was addictive. Use of a nicotine patch did not result in a statistically significant difference in abstinence rates among those who did not also use some other form of assistance (logrank test, P = .466). It did make a statistically significant difference when used in combination with another aid (logrank test, P = .017). At 6 months, abstinence rates were 15% for those without other forms of assistance whether or not they used a patch, 10.9% (95% confidence interval [CI] = 5.1-16.8) for those with other assistance who did not use a patch, and 18.8% (95% CI = 5.7-31.8) for those with other assistance who did use a patch.


CONCLUSIONS
The nicotine patch appears to be an important aid to smokers who want to quit, primarily when used as an adjuvant to other forms of assistance.


IMPLICATIONS
Further studies are needed to determine what factors are associated with quitting success among patch users.