long term nicotine patch use?

June 18, 2005 12:06 PM

I'm wondering if using the nicotine patch long-term is an option. I've used it to quit smoking before, but enetually when I come off it I tend to slip into drinking or back to smoking. What are the perils of nicotine, specifically, apart from the perils of smoking itself? If I have to be addicted to something, wouldn't a patch be less harmful than pack-a-day smoking or sixer-a-night drinking? Obviously a total eradication of all addictions would be best, but please give me advice on whether this could be a short-term harm-reduction approach, or if the patch is just too dangerous to use for months on end.
posted by anonymous to health (10 comments total)

Nicotine is a neurotoxic vasoconstrictor that, outside of stimulating the central nervous system, constricts the blood vessels and increases the heart rate and blood pressure of someone using it. Prolonged use causes arteriosclerosis, increased blood pressure and may contribute to heart disease. There is also the possibility that the nicotine itself is a carcinogen but the studies on that are just starting.

Considering that smoking already increases your risk of heart disease, lung disease and cancer of various areas while giving you arteriosclerosis anyway, trading all of those for two of those is better than nothing.
posted by 517 at 1:08 PM on June 18, 2005

A friend who is a nurse says most of those she's seen quit smoking permanently, cut those patches into 8/ths or 16/ths and stuck on just a dab when they had the craving later, after they quit using them all the time.
YMMV.
posted by unrepentanthippie at 1:15 PM on June 18, 2005

I know I've read that you aren't supposed to cut the patch-- supposedly it screws up the time release and you start leeching extra nicotine off the cut edge. Makes sense, though, considering that the step 2 and 3 patches cost the same as step 1, it could just be to keep people from making four boxes of 3's out of a box of 1's.
posted by cosmonaught at 2:12 PM on June 18, 2005

if you really need nicotine, there are alternatives to smoking--safer alternatives. i'm still a smoker, but i don't limit myself to cigarettes. chewing tobacco, pipe tobacco, even snuff (although that adds the additional risk of deteriorating septum), shave off a very small amount of your total life, whereas (continued, habitual) smoking will shave off many, many years.

a lot of smoking has to do with mental addiction to the routine, as well. the physical addiction is brutal, but the we put ourselves in schedules, give ourselves little routines (even lazy motherfuckers like me) and one of the hardest things to do will be to not have that cigarette during break, or what have you. Or even if it's not that kind of routine, the process of lighting and inhaling a cigarette is a something you "do."

if you can break that barrier, i highly suggest smokeless tobacco. at least if you continue that, it'll be a hell of a lot safer. there are still risks, and unpleasant effects--bad breath, yellower teeth...with chewing tobacco, burning a hole in your lip. again, though, the risks of smokeless tobacco take an even longer amount of time to manifest themselves than the obvious risks of cigarette or cigar smoking.

if you're really 'jonesin' for that puff, just use a little self-restraint and force yourself for a chew. even nicorette gum is a good alternative. 90% of those who succesfully quit and regress (well, that's POV...begin smoking let's say ;) back into smoking do so because of nostalgia--which puts them in the loop of it again. if you're not physically addicted anymore, the only thing that will start you smoking again is missing the days of chilling out with a mighty fine rolled cigarette. if you can withstand that, chew away.

pipe tobacco is also a lot better than just straight cigarettes. smoking regular tobacco out of a bong (they do sell water pipes in cigar stores), or out of a pipe is so much more effective, as well. imagine that quick trip you get from inhaling cigarette smoke deep, and amplify it a bit--it's crazy. chewing tobacco also gives stronger effects; whether this is positive or negative is up to you.

best of luck either way. i wouldn't quit cold turkey, i'd restrict myself to lesser, but still enjoyable forms of everything: dont stock yourself with any hard liquor, just stick to beer; dont stock yourself with cancer sticks, just alternatives.
posted by Lockeownzj00 at 3:22 PM on June 18, 2005

Nicotine itself can paralyze the ciliated cells in your respiratory tract that normally sweep debris out of the lungs. As a result, more 'crap' tends to stay inside, with the usual consequences.

That said, patches are obviously orders of magnitude better than smoking, chewing, and so on.
posted by NucleophilicAttack at 3:47 PM on June 18, 2005

It's probably true that you aren't supposed to cut up the patches, it probably does screw with the "delivery system", but I think the point was that in such tiny quantities, even if it does mess with the time release, you'd get one tiny release and then the blood levels would taper off gradually.
She was talking in terms of someone using one of these squares every few days or once in a while, not several times a day.

IANAD.
posted by unrepentanthippie at 4:20 PM on June 18, 2005

I've cut the patches. It works perfectly well.
posted by Wolof at 8:29 PM on June 18, 2005

If anyone is still reading this, I'd recommend snus, the Swedish variant of smokeless tobacco.

The flavors are more varied than the American variants, and the Swedish gov't claims that snus users have the same rate of oral cancers as the general population, so its about as safe as tobacco use can be.
posted by pandaharma at 10:57 AM on June 19, 2005 [1 favorite]

Perhaps slightly off-topic: I was pleased when these nicotine patches were finally made over-the-counter. I never did prescribe them, because they violate the first principle of medical ethics: first, do no harm.

Nicotine is harmful; it activates both autonomic systems (parasympathetic and sympathetic) at the ganglion. Since the two systems are supposed to oppose each other, this is not a healthy situation. It's like comparing a car coasting at 35 mph to a car with the accelerator and brake both floored, traveling at 35 mph. The latter car is subjected to much more wear and tear.

Just stop ingesting harmful compounds. You are a man, after all, not a monkey, and you are imbued with free will.
posted by ikkyu2 at 4:01 PM on June 19, 2005

It's dangerous to cut the patches - don't do it.
posted by agregoli at 10:49 AM on June 20, 2005