Big Tobacco’s nicotine replacement ambitions revealed 

Medical politics

By Tessa Chapman

22 Aug 2017

Big Tobacco’s ambition to capture the nicotine replacement therapy market it once saw as a threat has been revealed after researchers gained access to decades’ worth of formerly secret industry documents.

The dossier known as the “Tobacco Papers” reveals companies that once viewed nicotine patches and gum as a threat to profits now embrace them as a business opportunity.

Tobacco companies have known for decades that, without counselling, nicotine replacement therapy (NRT) hardly ever works, and that consumers often use it to complement smoking, according to researchers from the University of California San Francisco who trawled through internal corporate documents of the seven major tobacco companies dated between 1960 and 2010.

Their findings were published this month in a paper in the American Journal of Public Health , which charts the tobacco industry’s shifting position over time.

In the 1950s tobacco companies developed nicotine replacements, but stopped out of concern that marketing such products would trigger Food and Drug Administration (FDA) regulation of cigarettes, the study claims.

Forty years later, after pharmaceutical companies began selling prescription NRT, tobacco companies learned many smokers were using NRT to supplement smoking rather than to quit.

But it wasn’t until 2009, once the FDA began regulating tobacco the industry reignited plans to “capture the nicotine market”, the paper claims.

Clinical trials show that NRT can help people quit smoking, but only if used in conjunction with counselling and in tapering doses, the authors wrote.

But in the US, over-the-counter availability of nicotine patches, gum and nasal spray makes it easy for smokers to get a nicotine fix in non-smoking environments.

“Although the tobacco industry initially viewed NRT as a threat, it found that smokers often combined NRT with smoking rather than using it as a replacement and began marketing their own NRT products,” the study claims.

The study’s lead author Dr Dorie Apollonio (PhD) said it was surprising to discover the industry came to view NRT as “just another product”.

“The tobacco companies want people to get nicotine – and they’re open-minded about how they get it.”

“Tobacco companies put out these products as a way to sidestep policies, by giving people a way to smoke without smoking.

“This can basically facilitate and normalize lifelong nicotine addiction.”

The FDA should consider regulating the ways in which NRT is being marketed and its over-the-counter availability, the study recommends.

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