Over the counter nicotine replacement therapy is more successful than therapy prescribed by a physician, according to a new study.

When nicotine replacement therapy (NRT) was first introduced, it was a prescription only medicine. Now the FDA has allowed both nicotine gum and nicotine patches to be made available over the counter (OTC). This has the advantage of allowing the smoker to avoid having to pick up a prescription. But how does the would-be quitter fare when left to his or her own devices like this? Researchers at the University of Pittsburgh studied cessation rates among smokers using prescription-only NRT and those using the OTC version. For gum, they found the OTC treatment led to a quit rate of 16.1 per cent after six weeks compared to only 7.7 per cent among those who used a prescription. At six months, the figures were 8.4 per cent and 7.7 per cent. Similar results were seen for nicotine patches - with OTC users achieving higher (but still low) success rates. The reasons for these differences between OTC and prescription-based NRT use are not clear. One might expect prescriptions to lead to higher success rates, because here you have the option of support from the doctor. However, research has shown that doctors don't always offer counselling or follow-up with NRT. They may also prescribe a dose of nicotine that's too low. The Pittsburgh researchers feel this still does not adequately explain the differences observed.

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