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Perceived safety of nicotine replacement products among general practitioners and current smokers in the UK: impact on utilisation
Alex Bobak

Despite Nicotine Replacement Therapy (NRT) being effective for smoking cessation, most smokers try to quit without it.
We tested the hypotheses that misperceptions of NRT safety might limit both the proportion of smokers interested in using NRT and the likelihood of it being prescribed. During a study of 2062 UK residents, all respondents who reported being smokers (30%; n=612) were asked about their attitudes toward smoking and smoking cessation products. Large proportions of the smokers agreed that "Stop smoking products with nicotine are just as harmful as cigarettes" (37%); and that NRT causes heart attacks (30%), lung cancer (29%), strokes (26%) and asthma (22%). Smokers who agreed that NRT is just as harmful as cigarettes were slightly less likely to have used NRT in the past (30% versus 38%; ns), and reported being less likely to use it during future quit attempts (14% versus 38%; p < .001) and being more likely to quit unassisted (56% versus 42%; p.010). In a second study, 205 UK General Practitioners (GPs) answered an internet survey that included the same questions regarding the safety of nicotine and NRT. While only 6% agreed that NRT is just as harmful as cigarettes, a substantial proportion of GPs incorrectly asserted that nicotine in cigarettes causes CVD (51%); strokes (49%) and lung cancer (41%).
The GPs who misperceived the safety of NRT were less likely to prescribe it (47% versus 61%) but this difference was not significant. These findings suggest that safety misperceptions impede the adoption of NRT in cessation attempts.

Alex Bobak
Wandsworth PCT, London