The Ontario Center for Addiction and Mental Health (CAMH) mailed free nicotine patches to smokers to see if they really help you quit without any behavioral support. And for one in four of participants who kept to the treatment, it did.

Smoking makes you look cool, everyone knows that. That’s why smoking is in movies and in TV shows. Smoking is in magazines and there’s even a couple of songs about it. Smoking, also, is one of the leading causes of preventable disease (and death) in the world.

So you know, that’s a lot to weigh against just looking cool.

But the real hook in smoking is that it’s addictive. More specifically nicotine is really, really addictive. In a recent CAMH Monitor survey, 13 percent of Ontario adults have reported to smoking daily. Looking for ways to bring that number down, CAMH researchers wanted to know if nicotine patches, by themselves, really do help people quit smoking.

“It’s relevant to study if nicotine replacement therapy without counselling works, because there are many people who purchase nicotine patches over-the-counter and attempt to quit without any support,” notes Dr. John Cunningham, CAMH Senior Scientist in Social and Epidemiological Research, and co-authors in their study published in JAMA Internal Medicine.

Previous clinical studies found that the patches, used in conjunction with behavioral supports, have an enormous impact in helping smokers break the habit. However, as is the case of the vast majority of users, who buy these patches over the counter and receive no support, nicotine replacement therapy doesn’t seem to impact quit rates.

So does self-medicating with patches work? To find out, CAMH recruited 999 ten-cigarettes-a-day smokers from across Canada by random-digit dialing. Five hundred of them were put in the test group and were mailed a five week supply of nicotine patches. The other 499 participants formed the control group and received neither patches nor counseling. After six months time, researchers came back to see it participants had been tobacco-free for the last 30 days.

“Among those who received patches, almost eight per cent reported being abstinent, compared with three per cent who had no intervention,” says Dr. Cunningham.

The five percent difference doesn’t sound like a lot until you consider that not all participants used the patches they received. Only 58 percent reported to applying them, and even among them not all followed the full course of treatment.

Overall, only 46 people (19 percent) used the full supply, meaning the patches worked for about one in four participants. Not bad.

The researchers also asked participants for saliva samples to measure for continine (a tabacco by-product) content to validate the reported results. Due to evaporation during transit (they were sent by mail) only half of the samples were usable.  Despite this, the trend towards abstinence was also higher in the patch-group than those who received no treatment.

While this study does not directly reflect these mass distribution initiatives, because study participants were recruited randomly and were not necessarily seeking help, the authors note that, “the results of the trial provide general support for direct-to-smoker programs with free mailed nicotine patches.”

Although nicotine replacement therapy is much more successful that the patches alone, if you’re struggling to quit smoking they could provide the extra push you need to stay tobacco-free. Many jurisdictions offer free nicotine patches and counseling to people who call a toll-free number, including the STOP program in Ontario.

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