To the Editor.
— Smoking prevalence is declining less rapidly among disadvantaged smokers than among the general US population. Disadvantaged smokers (defined by low income, education, or employment) appear to be less able to quit than the general population.1,2 While poor smokers are unlikely to attend formal smoking cessation therapies, their prevalence of smoking-related illnesses is higher than that in the general population.2The effectiveness of smoking cessation treatments in poor smokers is not known, but several factors suggest transdermal nicotine (TN) therapy might be effective. Transdermal nicotine is safe and easy to use, has very good compliance, and increases quit rates by a factor of 2.5 even when smokers do not attend concurrent behavior therapy.3As a result of a program to donate free TN patches, we tested the efficacy of TN in poor smokers. In 1993, 6-week courses of a 24-hour TN system (Prostep) were
Howard TS, Hughes JR. Smoking Cessation and the Nicotine Patch. JAMA. 1995;274(3):214. doi:10.1001/jama.1995.03530030034017