To the Editor.
—We read with interest the meta-analysis of nicotine patch studies by Dr Fiore and colleagues.1 Their article is a major contribution to the literature and provides important information about several issues regarding the use of nicotine patches. However, we are concerned with their suggestion that "the nicotine patch might be offered first with minimal assistance" and, if this failed, move on to using the patch with an "intermediate-intensity adjuvant," such as support and followup provided via telephone or using the approach detailed in the National Cancer Institute's manual for physicians.2 Many readers may conclude that the patch is effective when used alone. We believe that such a conclusion is premature and is not adequately supported by available research.At a minimum, all of the studies analyzed by the authors provided instructions on use of the patch, some brief advice, and at least several follow-up contacts.
Haxby D, Toffler WL. Using the Nicotine Patch to Stop Smoking. JAMA. 1995;273(3):181-182. doi:10.1001/jama.1995.03520270015008