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Therapy to quit smoking ‘no help’

south China Morning Post – Jan 11, 2012

Clear the Air says : because the smokers can still go out and smoke in bars with only a miniscule chance of being caught, they will continue to do so until the Government follows the legislation in many overseas territories and places the onus to prevent smoking on the premises’ licensees including patio areas and within 10 meters of doorways. Without places to go and smoke socially, many more nicotine addicts will quit.

US study shows nicotine gum and patches are not much use in kicking the habit, but Hong Kong still sees value in such programmes

Nicotine gum and patches may be no help in kicking a smoking habit and may even backfire in the case of heavy smokers, according to a long-term study conducted in the United States.

Such therapy is recommended in programmes trying to get people to quit smoking in Hong Kong.

US researchers say they have found no difference in long-term quit rates with or without the use of gum and patches.

“We were hoping for a very different story,” said Professor Gregory Connolly, director of Harvard University’s Centre for Global Tobacco Control in Boston and co-author of the study. “I ran a treatment for years, and we invested millions in treatment services.”

In Hong Kong, the Department of Health works with medical institutions such as the Tung Wah Group of Hospitals to run clinics to provide free nicotine replacement therapy for people seeking to quit smoking.

The University of Hong Kong, for instance, recommends using gum or patches if smokers find withdrawal symptoms too much to handle.

However, the cost of such therapy seems to be a deterrent – the university found only about a third of the 10,000 or so respondents in a survey actually used them, said Professor Sophia Chan Siu-chee, head of the nursing department.

“It’s funny. It’s about the same amount as smoking for a week, about HK$200, but people don’t want to spend money on [gum or patches],” Chan said.

She said that for now, HKU would continue to recommend using gum and patches to quit smoking.

“The nicotine replacement therapies are more to help them through the process of quitting. It’s like what methadone clinics do for heroin addicts, giving them lower doses to ease them off withdrawal symptoms, not necessarily to prevent relapse.”

In general, at least half of those who tried to quit smoking relapsed, and so psychological readiness was more instrumental to preventing a relapse, she said.

In the Massachusetts study, the researchers followed the progress of 1,916 adults during the past decade, including 787 who said at the start of the study that they had recently quit smoking.

The researchers interviewed them three times, about once every two years, on their use of gum, patches and other such products, their periods of not smoking and their relapses.

At each stage, about one-third of the people trying to quit had relapsed, the study found. The use of replacement products made no difference, whether they were taken for a recommended two-month period (usually they were not), or with the guidance of a professional cessation counsellor.

Heavy smokers – defined as those who had their first cigarette within half an hour of waking up – who used replacement products without counselling were twice as likely to relapse as heavy smokers who did not use them. The findings were published in the journal Tobacco Control this week.

In Hong Kong, smokers who sign up for services to quit smoking undergo individual or group counselling and are prescribed nicotine replacement therapy (NRT) or non-NRT medication. The Tung Wah Group of Hospitals programme admitted 717, 1,288 and 2,756 people in 2009, 2010 and last year respectively. The health department subsidised the hospital group with HK$21 million for 2011-12 for the smoking cessation programme, a department spokesman said.

A combination of higher taxes, social factors and effective antitobacco campaigning in the city is thought to have helped cut the number of people aged 15 and above who smoke to 11.1 per cent, down from 12 per cent in 2009. The rate is one of the lowest in the developed world.

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