Patches help smokers quit.

Most of the nation's 50 million cigarette smokers would like to kick the habit, according to the U.S. Office on Smoking and Health in Rockville, Md. But nicotine addiction thwarts the long-term success of many would-be abstainers. What's an addict to do?

How about slapping on a nicotinelaced skin patch?

Nearly 1,000 smokers wore such patches for six to 12 weeks at nine U.S. smoking-cessation clinics. Researchers randomly assigned each volunteer to receive one of four daily nicotine doses through the skin: 21, 14 or 7 milligrams, or a placebo dose of less than 1 mg. The patches offered a dramatic, dose-related benefit, the investigators report in the Dec. 11 Journal of the American Medical Association.

The lowest active does (7mg) warded off nicotine-withdrawal symptoms - including irritability, anxiety, difficulty concentrating, restlessness and nicotine craving - about as well as the highest dose. But the higher the dose, the less likely a person was to resume smoking within six months of the study's start. At every stage of the trial, the 21-mg group contained more than twice as many successful abstainers as the placebo group. Overall, the abstention rates were similar to those obtained with nicotine-dispensing chewing gum, says Stephen Rennard of the University of Nebraska in Omaha, a co-director of the skin patch study. However, he adds, nicotine gum is more difficult to use and can cause adverse effects such s stomach upset.

Even among smokers who relapsed, those receiving active doses of nicotine from the patch "smoked much less than their baseline habit," Rennard says. This suggests that people with intractable nicotine addiction might reduce their cigarette consumption - and their exposure to carcinogens - through longer-term or even permanent use of nicotine-dispensing skin patches, he says.

On Nov. 7, the FDA granted Alza Corp. of Palo Alto,Calif., and Marion Merrell Dow Inc. of Kansas City, Mo., permission to begin marketing the patches under the trade name Nicoderm.