—We thank Dr Richardson, Dr Swartz, and Drs Haxby and Toffler for their comments concerning our article on the effectiveness of the nicotine patch for smoking cessation.Richardson is correct in stating that the nicotine patch does not produce the same subjective effects as a cigarette and is undoubtedly less reinforcing. Therefore, the patch is unlikely to support long-term addictive use in the same manner as cigarette smoking. Of course, most clinicians do not expect or want the nicotine patch to become a permanent replacement for smoking. Rather, the hope is that the nicotine patch will make quitting smoking less unpleasant and more successful. Products such as nicotine inhalers and intranasal sprays have been developed that appear to mimic some of nicotine's reinforcing actions with high rates of long-term use.1 The use of such devices may help smokers stop smoking, but questions remain about whether smokers will
Fiore MC, Smith SS, Jorenby DE, Baker TB. Using the Nicotine Patch to Stop Smoking-Reply. JAMA. 1995;273(3):182. doi:10.1001/jama.1995.03520270015009
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