Is it stupid to stay on nicotine patches long term?
October 10, 2006 1:48 AM Subscribe
What are the implications of using NRT (specifically, the nicotine patch) for longer than you're supposed to?
I've been giving up smoking (again) and have found the nicotine patch to be a godsend. It's really helped in the day-to-day dealing with cravings, and I haven't been smoking during the day at all. However, I still have a huge problem when out in the pub and someone else is smoking. I'd estimate that over the last 5 weeks, on a number of separate occasions (<10), I've had a cigarette or a few drags on someone else's cigarette whilst out on the booze. It's been getting better, but I'm still a bit crap when I'm out.
So here I am approaching the time at which I'm supposed to start ramping down the nicotine dosage and I'm not confident I've dealt with the "habit" part of smoking (which is what NRT is supposed to help you do). Is there any reason why I shouldn't just stay on max dosage for longer?
I've been giving up smoking (again) and have found the nicotine patch to be a godsend. It's really helped in the day-to-day dealing with cravings, and I haven't been smoking during the day at all. However, I still have a huge problem when out in the pub and someone else is smoking. I'd estimate that over the last 5 weeks, on a number of separate occasions (<10), I've had a cigarette or a few drags on someone else's cigarette whilst out on the booze. It's been getting better, but I'm still a bit crap when I'm out.
So here I am approaching the time at which I'm supposed to start ramping down the nicotine dosage and I'm not confident I've dealt with the "habit" part of smoking (which is what NRT is supposed to help you do). Is there any reason why I shouldn't just stay on max dosage for longer?
I've been seriously quitting smoking for 10 years (have a 9 year membership at quitnet- a place which can answer a lot of your questions) and I'm currently 9 months quit. I also run a small private board for quitters (for non sunshine-enema types) that has been operational for about 3 years and has about 150 members.
I have to tell you that I had been quit over a year when I had a drag on someone else's cigarette. It took me 4 months to be smoking again full time. I strongly suggest you deal with this impulse firmly by making the decision (to not smoke) before you enter the environment, and running the idea through your head a number of times, so that when your inhibitions are lowered, you are not tempted.
Anecdotally, I know of a number of people who have remained on NRT (primarily the gum) past the suggested period. There is reportedly an increased (IIRC) risk of mouth cancer with continued use, however, not in the general range of risk from smoking.
Sometimes the patch companies offer a support line you can ring to find out recommended usage and whether there is an issue with staying on the patch longer.
My opinion (with no medical training or knowledge) is that to stay on the higher level of patch while NOT smoking is far healthier than risking a quit.
posted by b33j at 3:01 AM on October 10, 2006
I have to tell you that I had been quit over a year when I had a drag on someone else's cigarette. It took me 4 months to be smoking again full time. I strongly suggest you deal with this impulse firmly by making the decision (to not smoke) before you enter the environment, and running the idea through your head a number of times, so that when your inhibitions are lowered, you are not tempted.
Anecdotally, I know of a number of people who have remained on NRT (primarily the gum) past the suggested period. There is reportedly an increased (IIRC) risk of mouth cancer with continued use, however, not in the general range of risk from smoking.
Sometimes the patch companies offer a support line you can ring to find out recommended usage and whether there is an issue with staying on the patch longer.
My opinion (with no medical training or knowledge) is that to stay on the higher level of patch while NOT smoking is far healthier than risking a quit.
posted by b33j at 3:01 AM on October 10, 2006
I have known a lot of people to have success with NRT. I've known a lot of people to struggle with quitting smoking with or without NRT.
posted by b33j at 3:03 AM on October 10, 2006
posted by b33j at 3:03 AM on October 10, 2006
Response by poster: My quitting history is similar to yours b33j - that story of a drag then full time smoking again has happened each time I've tried before. It's not 10 years yet, but it's getting close to 5.
Any chance of an invite to your private board? My longest quit (8mo) was with the assistance of Netdoctor, but their forums were a little over-moderated for my taste. Email's in the profile.
posted by handee at 3:08 AM on October 10, 2006
Any chance of an invite to your private board? My longest quit (8mo) was with the assistance of Netdoctor, but their forums were a little over-moderated for my taste. Email's in the profile.
posted by handee at 3:08 AM on October 10, 2006
I quit smoking 4 years ago and I still have enormous cravings when out with smoking friends. A couple times a year I'll cave and have a cigarette, but I don't beat myself up about it. And it hasn't lead to increased cravings during non-socializing -with-smoking-people-times. Actually, I usually can't finish the cigarette and find the whole thing to be incredibly disgusting though somewhat nostalgic. I was living in NYC when I quit, and the ban on smoking really eased the transition.
So for me, the addiction is gone but the temptation will always remain. It sucks. Good luck!
posted by defreckled at 3:10 AM on October 10, 2006
So for me, the addiction is gone but the temptation will always remain. It sucks. Good luck!
posted by defreckled at 3:10 AM on October 10, 2006
Yeah... the patch isn't going to help you with not wanting to smoke when your friends are smoking or you're out drinking (that's the psychological addiction, not the physical one). I'd say you'd be right to just ramp down according to the schedule of the patch - in theory you should still be fine during the day, and hopefully you'll be able to get ahold of yourself in time when you're out drinking.
posted by antifuse at 3:29 AM on October 10, 2006
posted by antifuse at 3:29 AM on October 10, 2006
The idea with NRT when I did it, about 11 years ago, was to reduce the dosage. The patch made it possible to control that dose, so you could reduce it. That's the way I did it, and it worked. It was about 8 months later that I screwed up and had a cigarette, followed by the spiral back to full-time smoker.
In my experience, having removed the nicotine issue, followed by the oral issue (which lasted only a few days) it was the desire for that full, SMOKE feeling in my lungs that was most difficult to handle. A few weeks into the quiting thing, I got some 420 and that was a godsend (but I think would have been the wrong thing, in the early stages).
You know, if you want to really quit, I'd strongly suggest giving up the pub thing for awhile. If that's your biggest source of temptation, then avoid it until you're better. My problem was when I found myself alone after work. It was impossible.
posted by Goofyy at 3:33 AM on October 10, 2006
In my experience, having removed the nicotine issue, followed by the oral issue (which lasted only a few days) it was the desire for that full, SMOKE feeling in my lungs that was most difficult to handle. A few weeks into the quiting thing, I got some 420 and that was a godsend (but I think would have been the wrong thing, in the early stages).
You know, if you want to really quit, I'd strongly suggest giving up the pub thing for awhile. If that's your biggest source of temptation, then avoid it until you're better. My problem was when I found myself alone after work. It was impossible.
posted by Goofyy at 3:33 AM on October 10, 2006
Gooffy - what's 420?
A herbal substitute for nicotine ;-)
posted by twistedonion at 3:49 AM on October 10, 2006
A herbal substitute for nicotine ;-)
posted by twistedonion at 3:49 AM on October 10, 2006
"420" is a special code word drug users use when referring to marijuana.
posted by Meatbomb at 5:26 AM on October 10, 2006
posted by Meatbomb at 5:26 AM on October 10, 2006
I haven't smoked for three and a half years now. I quit with the patch, stepping down a dosage level every week and hanging onto that last level three weeks longer than I was supposed to. I asked my doctor and he said he didn't care if I slapped a patch on every day for the rest of my life. So long as I wasn't coating my lungs in tar and other gunky stuff, he was cool with it. He said any topical nicotine delivery system was way better than inhaling.
The patch will do nothing to help that hand to mouth addiction or that feeling that you need your best friend the cigarette to hang out with you in social situations. That's all you.
Cutting it down as much as you have is awesome and your lungs will thank you. However, please be careful not to smoke with a patch on. My cousin also had a slip while out drinking and overdosed on nicotine. Got an expensive ride to the hospital in an ambulance.
Good luck with your quit. It's the most awesome feeling in the world to beat that addiction.
posted by justlisa at 5:36 AM on October 10, 2006
The patch will do nothing to help that hand to mouth addiction or that feeling that you need your best friend the cigarette to hang out with you in social situations. That's all you.
Cutting it down as much as you have is awesome and your lungs will thank you. However, please be careful not to smoke with a patch on. My cousin also had a slip while out drinking and overdosed on nicotine. Got an expensive ride to the hospital in an ambulance.
Good luck with your quit. It's the most awesome feeling in the world to beat that addiction.
posted by justlisa at 5:36 AM on October 10, 2006
How 'bout we try to answer the question, hmmmm?
From what I've learned and from my own personal experience with the patch, you can pretty much use it as long as you want to, but it's really not a good idea to smoke WHILE the patch is on.
posted by tristeza at 7:10 AM on October 10, 2006
From what I've learned and from my own personal experience with the patch, you can pretty much use it as long as you want to, but it's really not a good idea to smoke WHILE the patch is on.
posted by tristeza at 7:10 AM on October 10, 2006
Nicotine is a posion to the cardiovascular system. Definitely avoid smoking while on the patch.
Most folks trying to quit find the most success when combining NRT with some sort of counseling.
Good luck!
posted by Riverine at 9:11 AM on October 10, 2006
Most folks trying to quit find the most success when combining NRT with some sort of counseling.
Good luck!
posted by Riverine at 9:11 AM on October 10, 2006
When I was quitting I asked my doctor if there would be any serious problems with staying on the patch past the recommended time. He told me that the nicotine wasn't an issue, but the chemical that allows the nicotine to pass through your skin can cause a nasty reaction if you don't move it from one day to the next.
posted by lekvar at 10:34 AM on October 10, 2006
posted by lekvar at 10:34 AM on October 10, 2006
I haven't had a cigarette in over two years (okay, two years, eight months and eight days, but who's counting?) thanks to the nicotine patch. I was on it longer than I was supposed to be, but the fact is, a nicotine patch is much better for you than smoking.
Using the patch (and ramping down) will help you break the physical addiction while you deal with the psychological addiction. I was never successful at doing both at the same time. Hence, the patch.
(or, what justlisa said.)
posted by pyjammy at 10:58 AM on October 10, 2006
Using the patch (and ramping down) will help you break the physical addiction while you deal with the psychological addiction. I was never successful at doing both at the same time. Hence, the patch.
(or, what justlisa said.)
posted by pyjammy at 10:58 AM on October 10, 2006
In my experience (2 year quit anniversary in 2 weeks!) after trying to quit 6 or 8 times, quitting smoking is a two step process. The first step is to break the association between smoking and certain activities, and the second is to withdraw from nicotine, a process much easier to deal with if you don't want a smoke every time you eat, drink, talk, play games, or screw.
Based on some this very basic common sense approach and using my experience with eating disorders and other compulsive/addictive behaviors, I developed my own program and it worked. I was off of NRT in 12 days, and I haven't had a cigarette since. It is a testament to the power of the addiction that I occasionally reach for invisible ashtrays while concentrating on an activity, though.
For 30 days prior to quitting smoking, I made smoking an activity that had to be done with total concentration. I couldn't read, talk on the phone, watch tv, eat, or do any trigger activity WHILE smoking. I went to the kitchen, sat in a chair, and smoked. If I was away from home, I would go to my car. No radio, no music. Just me and my sad little habit. In addition to this, I greatly delayed smoking after a culminating trigger activity, such as finishing a meal or having a coffee or a beer. I started by waiting about 15 minutes, and upped it over the four weeks. I also delayed smoking after stressor events. By the time I threw out my ashtrays and smoked the last coffin nail, I had greatly reduced (but not eliminated) the psychological association I made between smoking and the activities of daily life.
The next part was NRT and reinforcing the habits I'd already begun to develop by using the popular 4D technique--Deep Breathe, Delay, Do Something Else, Drink Water. And while I was quitting, I also stopped drinking. From past experience, I found that drinking relaxed me so much that it was too easy to say "aw fuggit, gimme one!" I still don't drink, but I could. I could have had a drink or two probably 60 days after quitting without a relapse.
My dad used NRT for a year after quitting, and he still had the shakes and nightmares and all that when he tossed the gum packets out. I say get it over with, and just do it. My dad finally did permanently quit but he smoked for 25 years before that. Now he's paying for it with bladder cancer, which has not been pretty. Just a few weeks ago I was watching my mom smoke outside the hospital while my dad was having half of his blood volume replaced upstairs. Craziness. I quit because I had an unrelated cancer, but thought it was ridiculous and insane to go have cancer treatment and then step outside for a smoke. The withdrawal nightmare was over in 30 days and my urges were almost nonexistent within 90 days. You just have to hang on for dear life until you get there. It's so worth it in the end. If someone told me that my life were ending tomorrow, I wouldn't even think about having a cigarette.
Good luck.
posted by xyzzy at 11:11 AM on October 10, 2006 [1 favorite]
Based on some this very basic common sense approach and using my experience with eating disorders and other compulsive/addictive behaviors, I developed my own program and it worked. I was off of NRT in 12 days, and I haven't had a cigarette since. It is a testament to the power of the addiction that I occasionally reach for invisible ashtrays while concentrating on an activity, though.
For 30 days prior to quitting smoking, I made smoking an activity that had to be done with total concentration. I couldn't read, talk on the phone, watch tv, eat, or do any trigger activity WHILE smoking. I went to the kitchen, sat in a chair, and smoked. If I was away from home, I would go to my car. No radio, no music. Just me and my sad little habit. In addition to this, I greatly delayed smoking after a culminating trigger activity, such as finishing a meal or having a coffee or a beer. I started by waiting about 15 minutes, and upped it over the four weeks. I also delayed smoking after stressor events. By the time I threw out my ashtrays and smoked the last coffin nail, I had greatly reduced (but not eliminated) the psychological association I made between smoking and the activities of daily life.
The next part was NRT and reinforcing the habits I'd already begun to develop by using the popular 4D technique--Deep Breathe, Delay, Do Something Else, Drink Water. And while I was quitting, I also stopped drinking. From past experience, I found that drinking relaxed me so much that it was too easy to say "aw fuggit, gimme one!" I still don't drink, but I could. I could have had a drink or two probably 60 days after quitting without a relapse.
My dad used NRT for a year after quitting, and he still had the shakes and nightmares and all that when he tossed the gum packets out. I say get it over with, and just do it. My dad finally did permanently quit but he smoked for 25 years before that. Now he's paying for it with bladder cancer, which has not been pretty. Just a few weeks ago I was watching my mom smoke outside the hospital while my dad was having half of his blood volume replaced upstairs. Craziness. I quit because I had an unrelated cancer, but thought it was ridiculous and insane to go have cancer treatment and then step outside for a smoke. The withdrawal nightmare was over in 30 days and my urges were almost nonexistent within 90 days. You just have to hang on for dear life until you get there. It's so worth it in the end. If someone told me that my life were ending tomorrow, I wouldn't even think about having a cigarette.
Good luck.
posted by xyzzy at 11:11 AM on October 10, 2006 [1 favorite]
Leave the patches on as long as you need to, but no more furtive drags. None. Because otherwise it'll all have been for nothing.
posted by Wolof at 4:57 PM on October 10, 2006
posted by Wolof at 4:57 PM on October 10, 2006
Assuming there's no bad reaction to the patch or the ingredients in it, is there anything wrong with doing the patch "forever"? My understanding is that nicotine itself ain't that bad, that it's more or less equivalent to caffeine, the problem with smoking is all the other chemicals and tars in the smoke. I know Wikipedia says nicotine is extremely poisonous, but we're not talking about eating a boxful of patches here. But then IANAD.
posted by davy at 6:29 PM on October 10, 2006
posted by davy at 6:29 PM on October 10, 2006
This thread is closed to new comments.
As long as you keep thinking it's alright to smoke you will never break the addiction. Seems to take real commitment to quit. The patches are useless. It's the habit that needs broken.
I can't say much because I'm still a smoker. Tried to quit a few times and the thing that caused me to fail was the occassional smoke. It's amazing how easy it is to justify. The advice above is just from personal experience and that of ex-smokers and (failed ex-smokers) around me.
posted by twistedonion at 2:53 AM on October 10, 2006