'V~~
Smokers sticking
to nicotine patch
By Karen Zagor and CUve Cookson
ede.ri- health experts in the
US tstima e that .1 , 000
Am==s dtie ea h day of
F
smoking-mated dise, cAccordiag
W . formn- surgeon general, the
nation's -.0m. regular cigarette
smokers an caught in the grip of an
addiction nore powerful than her-
oin. Nico=e patches attached to
the upper irm are the latest candi-
daTe for a =iracle cure.
U=de,-' Jewer than 4 per cent of
smokers tei the habit, according
to some ammates. The advent of
hypn tis=- od cotine-impre gnat ed
chew0ing r=. acupuncture and
i behaviow-modification therapy
, have imp:-d the odds, but most
I would-be -=-=okers still fail.
Nicotint patches, which have
been on ---a market for less than
four m---s. arie selling almost as
quickly a, -.hey can be made. Alm
which rn,-ms the Nicoderm patch.
sad its plint has been operating 24
hours-a-.:ii-!, seven days-a-week
since J-mry to meet demand. In
Orily two ind a half months Nicod-
rm, chLiad up 360m (05m) in
M. _Wi. knew that there would
be a st:.zg reaction,- a company
spokeswo= said. "but we did not
expect s= amazing demaud for
the prod='. - . , ~ . . .
The te=ology behind patches is
young, b= not new. A patch for
motion n=ness has been available
in the - ance, 1981. The product
looks iiie i= ordinary sticking plas-
ter. It u=ay has a reservoir to
hold the drug, which enters the
bioodstr= by permeating the skin
at a reguhied rate.
With =iditional tablet meLca-
tions the --rug quickly passes from
the intes=e to the liver, where
enzymes -den digest most of the
medication before it has had a
chance co work- As a results tablets
often cc-m high concentrations of
medicine Drugs administered
through a batch reach the Liver at a
slower r= after they have already
started = work. Consequetitly,
low:r doses can be administered,
i gen rally ~,.th fewer ~ide-effects.
While =otine is the addictive
ingredle= = cigarettes, the biggest
risks are --sociated. with the rurro-
i samines. =rs and other particulates
unleashe-, when a cigarette is lit.
By pr7xiing smokers with nico-
tine in a ~!ss totc form the patches
give.smx-_rs time to change their
bebavioi= and give up cigarettes
withou, Fffering the irritabiLity,
lack of :i-mcentration and other
SYMPLO.- f rucotine withdrawal.
is
The overriding advantage of
patches over rucotine-impregnated
chewing gum is that they are easier
to use. V,91Ue gum allows patients to
regulate the nicotine intake, in
practice many people tying to give
up tend to chew gum maniacally,
releasing too much nicotine too
quickly and making themselves ilL
The Food & Drug Administration
has approved three nicotine patches
for prescription sales - Habitrol
marketed by Ciba Geigy, Nicoderm,
by Marion Merril Dow and ProStep
marketed by American Cy-mid's
Lederle unit, A fourth patch, to be
marketed by Warner Lambert, is
waiting for approval. . :- --.
The main difference between the
competing patches is the mecha-
nism for controlling entry into the
bloodstream. Some, like Nicoderm,
have a special membrane which
controls the flow of nicotine. Others
use the skin itself to control the
drug's flow into the bloodstream.
The doses also differ; ProStep comes
in one strength only, while Nimd-
erin and Habitrol offer patches with
increasingly reduced doses.
The patches seem to be effective.
A study of Nicoderm's product,
presented last December in the
Journal of the American Medical
Association, showed that it had a
six-week success rate of 61 per cent
compared with 27 per cent for the
placebo.
-After six months, 25 per cent'of.
the patients originally treated with
patches were still not smoking com-
pared with 11 per cent of the pla-
cebo group. The patches work best
for heavy smokers and are not rec-
ommended for those who smoke
less than one pack a day. - ~ -)
They are also most effective in-
conjunction with behaviour-modifl-
cation therapy. ProStep offers free
phone therapy from stooking-cessa-
tion experts: Lederle has offered to
reimburse pharmacists for time
spent educating patients.
Stephen Rennard. one of the chief
investigators in the transdermal
nicotine study group, is enthusias-
tic about patches as a means of nic-
otine replacement, but cautions
that "this won't cure everybody".
Dv-naGen. a Massachusetts bio-
technology company, is starting
chnical trials of an injectable non-
nicotine material called NicErase,
wKichitcl2im willdothesamejob
as the patches. It "eliminates the
need for the harmful and addictive
nicotine.- says Lndu Mumi. DynaGen
president.
C;1
CD
co
Ln
BATCo document for Province of British Columbia 26
October 1999