Nicotine patches while smoking

TazziRN, RN · Jun 17, 2006

Ooooooohhhh.......smoking while wearing the patch increasese the risk of having an MI.....

Nascar nurse, ASN, RN · Jun 17, 2006

I've already emailed the magazine about this issue - but hard to say if anyone will actually read this and do any kind of retraction

EricJRN, MSN, RN · Jun 17, 2006

The first page of that journal article should allay your fears regarding both the affiliation issue and the safety issue:

At the bottom of page 1: "Jed E. Rose, PhD, VA Medical Center and Department of Psychiatry, Duke University Medical Center, Durham, NC; Frederique Behm, BA, Prity Kukovich, BA, Department of Psychiatry, Duke University Medical Center, Durham, NC; Eric Westman, MD, MHS, VA Medical Center and Department of Medicine, Duke University Medical Center, Durham, NC"

From the Introduction on page 1: "All NRT products have labeling that admonishes the smoker from continuing to smoke while using NRT. The rationale behind this instruction is twofold: Not only are efforts to maintain abstinence sabotaged by any smoking after a target quit-smoking date (Kenford et al, 1994; Westman, Behm, Simel, and Rose, 1997), but it is also widely believed that continuing to smoke while using NRT could lead to symptoms of nicotine overdose, such as nausea and vomiting, and in extreme cases, death... However, studies of the effects of using NRT concurrently with cigarette smoking, as well as studies of high-dose NRT using multiple skin patches or combinations of two or more forms of NRT have found no evidence of dangerous consequences..."

If Woman's World does email you back, try to go easy on them.

RobCPhT · Jun 17, 2006

Patches while smoking is a big NO NO!! What are they thinking telling people to do this??

EricJRN, MSN, RN · Jun 17, 2006

Patches while smoking is a big NO NO!! What are they thinking telling people to do this??

Where is the study that shows any increased risk? The authors cite studies that show no increased danger.

meownsmile, BSN, RN · Jun 17, 2006

Uhmm, can they say nicotine overdose. Theres a reason the patch materials tell you not to smoke while using them.

EricJRN, MSN, RN · Jun 17, 2006

allnurses Guide · Jun 17, 2006

Hmmmmm.... I honestly believe that if using the patch concurrently with smoking, along WITH careful monitoring from an MD... I believe that IF it were found that this method was highly effective in helping someone to quit... perhaps the benefits in the long run would outweigh the risks?

Nascar nurse, ASN, RN · Jun 17, 2006

Hmmmmm.... I honestly believe that if using the patch concurrently with smoking, along WITH careful monitoring from an MD... I believe that IF it were found that this method was highly effective in helping someone to quit... perhaps the benefits in the long run would outweigh the risks?

I agree with you 100%. I am a smoker and just recently FAILED AGAIN at an attempt to stop smoking (using the patch). This is a horrible thing to try and give up for good. It has got a shameful hold on me that I just can't seem to get past (and I'm a pretty stubborn person).

This would be a great solution if it really worked, BUT I don't think the Duke study really implies it is ready to be implemented in the general population and the magazine reports it as a perfectly safe solution to stop smoking.

Eric.. Ok, ya caught me... I skimmed thru some parts of the article and didn't catch the affiliation with Duke University. Thanks for pointing that out.

Nascar nurse, ASN, RN · Jun 17, 2006

I'm paying attention

:uhoh3:

You are right - I tried to find medical studies related to the risks of nicotine overdose while using patch and smoking. Couldn't really find a true medical study, but lots of other info on other sites stating this is not safe.

As for myself, when I have tried to quit smoking and then have one of those all out nicotine fits and have ripped the patch off to light up (which is also a no-no, but hey I'm human - and fairly healthy) I can just feel the light headedness and the heart beat pounding from having to much nicotine.

I guess my main point was this has NOT been proven safe for every John Doe around and therefore should not appear in print as if it is.

marilynmom, LPN, NP · Jun 18, 2006

Hmmm this is interesting. I'm looking on medline and am only finding studies showing people in studies smoking while on the patch or a placebo and no reports of overdose like this one (I always thought it was dangerous to smoke while on the patch!?):

Abstract: The effect of transdermal nicotine patches on ad libitum cigarette smoking was examined in 30 subjects by measuring behavioural, biochemical and subjective aspects of smoking during a week of smoking without patches, and then a week each of nicotine and placebo patches in a randomised double blind crossover design. While wearing nicotine patches the subjects did not reduce the number of cigarettes smoked, but their expired carbon monoxide was reduced by 14%, they obtained less satisfaction from their cigarettes, and reported fewer and weaker urges to smoke. Down-regulation of nicotine intake from cigarettes was imprecise, such that when subjects wore nicotine patches their post-cigarette plasma nicotine concentration increased to an average of 45 ng/ml compared with 37 ng/ml in both no patch and placebo patch conditions. As the nicotine patches produced a plasma nicotine concentration of 15.9 ng/ml in abstinent subjects, this suggests a 22% reduction in nicotine intake from cigarettes while wearing nicotine patches. No serious symptoms of nicotine overdose were reported. It is suggested that the continuous absorption of nicotine from the patch may cause a build-up of acute tolerance to both toxic and pleasant subjective effects from smoking.

Psychopharmacology [Psychopharmacology (Berl)] 1992; Vol. 106 (3), pp. 421-7.