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John R. Hughes, MD

JAMA. 1995;274(17):1390-1391.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

The two studies assessing the safety and efficacy of high-dose nicotine patch therapy by Jorenby et al¹ and Dale et al² in this issue of THE JOURNAL raise four questions: Should higher-dose nicotine patches be used? Should nicotine patch therapy be tailored to achieve 100% replacement? How effective is the nicotine patch when given with no physician advice, ie, in over-the-counter—like conditions, in comparison with its effectiveness with physician advice, in prescription-like conditions? How much is its efficacy increased by adding behavioral therapy?

See also pp 1347 and 1353.

Dale et al² found that 22-mg patches underdose the majority of smokers and that higher doses are safe, provide better withdrawal relief, and appear to increase efficacy. Their results are supported by other studies, which found that standard-dose patches (15 to 22 mg/d) provide less than 100% nicotine replacement³; greater nicotine replacement decreases withdrawal symptoms and increases . . . [Full Text PDF of this Article]

Author Affiliations
From the Department of Psychiatry, The University of Vermont, Burlington.

Footnotes
Dr Hughes has received consulting fees, grants, and honoraria from Abbott Laboratories; Adis International Consumers Union; American Association of Psychiatrists in Alcoholism and Addictions; American Cyanamid; the American Medical Association; American Medical Video; the American Psychiatric Association; AlzaCorporation; Boehringer-lngelheim; Bruno and Bruno; Burroughs-Wellcome; Cahners Healthcare Communications; Ciba-Geigy Corporation; Corporate Health Policies; Dynagen; Edelman Communications; Eli Lilly; Healthcare Communications Network; Humphrey, Farrington, and McClain; J. Wiley & Sons; Kabi-Pharmacia-Leo; Lederle Laboratories; Lifesign; Manisses Communications; Marion Merrell Dow; McNeil Pharmaceuticals; Medco Management; Medical Age Publishing; Medical Economics; Medical Marketing Group; Miller-Fenwick Inc; the National Institutes of Health; Neuromedical Technologies; Orbis, Inc; Neuroscience Ventures; Nissen, Lumsden & Associates; Palo Alto Center for Pulmonary Disease Prevention; Parke-Davis; Princeton Scientifics; Smith-Klein Beecham; Stephen R. Fine & Associates; Symedco; and Wilmer, Cutler and Pickering, all of whom either produce stopsmoking products or educational materials or are involved in tobacco litigation.

Reprint requests to Department of Psychiatry, The University of Vermont, 38 Fletcher PI—Ira Allen School, Burlington, VT 05401-1419 (Dr Hughes).

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