Why Nicotine Patches Don't Work

Nicotine acts in the brain by stimulating nerve receptors that are involved in transmitting certain types of information, and helping you to focus. It is shown that very tiny doses of nicotine, which you can obtain by chewing the corner of a piece of nicotine gum, produce measurable improvements in mental tasking.

But the brain is very adaptive, and if you keep flooding the inside of your skull with nicotine these same receptors become less sensitive in order to compensate for all the drug-induced stimulation. Stop smoking, and the low-sensitivity receptors, no longer driven by nicotine, leave activity in this section of the brain slow and uncertain. This leaves you muzzy, unfocused, irri­table and unable to concentrate.

This is exactly what scopolamine, the 'truth drug' does; it reduces the sensitivity of the same nerve impulses by blocking these same receptors. It is shown that taking away a smoker s cigarettes leaves him or her in a state that exactly mirrors the effects of the 'truth drug'. It is no wonder that, once the last cigarette has been stubbed out and nicotine levels in the brain start to fall, the smoker soon starts to crave the next cigarette just to get his or her brain back up to speed.

Nicotine isn't exactly a health food, but it is the carbon monox­ide, free radicals, tars and other combustion products in the smoke which do the damage that leads to the many diseases that smokers are so prone to. Hence the nicotine patch, which cleanly and safely dulls the craving for nicotine, and allows smokers to wean themselves painlessly off their habit. Except that patches don't work. The early trial results which seemed to show how very effective the patches were in helping smokers to give up were, it now appears, somewhat skewed, and presented in such a way as to promote the sales of these products. Initial enthusiasm was damped by subsequent less promotional trials. A well-designed English study in 2000, for example, revealed that after a year on patches only 10% of the original abstainers remain non-smokers - a rate hardly distinguishable from placebo.

Patches don't work because they don't deliver the nicotine in a way that satisfies. The smoker gains a hit of nicotine with every drag, which produces a nicotine spike that enters the lungs, the bloodstream and finally the brain. The patch, on the other hand, delivers a slow, even trickle of the drug into the blood which, most smokers find, just doesn't hit the spot. Just as bad, patches give no hand-to-mouth action, which is one reason why they are so poor at preventing weight gain in smokers trying to give up.

Allen Carr, "The Easy Way To Stop Smoking." Amazon