To the Editor.— Dr Warner and colleagues1 questioned whether users of nontobacco nicotine delivery products also would use conventional tobacco products. They noted that over-the-counter availability of nicotine-containing pharmaceuticals would likely increase the use of these products as partial substitutes for smoking.
Even prior to their over-the-counter availability, nicotine-containing pharmaceuticals have been used in combination with conventional tobacco products in studies of smoking cessation.2-5 The particular type of allowed combination has varied widely. During an investigation of nicotine skin patches, participants could smoke an average of 1 cigarette per day over 4 weeks.2 Similarly, participants in an 8-week trial of transdermal nicotine patches who reported irregular or intermittent smoking were allowed to continue using the medication provided they continued to try to quit smoking.3
In another study, subjects with chronic obstructive pulmonary disease were given up to 30 pieces of nicotine polacrilex gum per day for 85 days with no . . . [Full Text of this Article]
