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Smoker/Nicotine Replacement Therapies

September 2006

Smoker/Nicotine Replacement Therapies

Medical University of Vienna: Nicotine replacement therapies are often more damaging than helpful

Vienna (16-02-2007). Nicotine replacement therapies have gained in significance for quitting smoking over the last 20 years. A new study published in the USA and in which researchers from the Medical University of Vienna have played a leading role, shows that replacement therapies are not only often ineffective, but can even be damaging.

The nicotine replacement therapy NRT, which has been used for some 20 years to help people quit smoking, was recently supplemented with additional nicotine preparations and new indications, even though long term studies have shown neither convincing nor measurable success. The consequences are multiple dependencies and the prolonging of the nicotine dependency. Yet replacement therapies are widely considered to be indispensable for quitting smoking – a view which has now been refuted by a study published in March by an internationally recognised group of toxicologists.

In particular, use by pregnant women and teenagers, as was officially recommended by the British Health Services in Great Britain last year, is criticised by the researchers because the toxic effects of nicotine are often swept under the carpet. “Nicotine, even in the form of replacement products, is a risk particularly for pregnant women and young people whose bodies are still developing”, according to internist and environmental hygienist Professor Manfred Neuberger from the Medical University of Vienna who worked together with the University Center for Internal Medicine I on the study. “Nicotine occupies receptors in the nervous system and leads to an increase in these receptors in the brain and other organs. With pregnant women the nicotine from both the cigarettes and from the replacement products can have harmful effects on the development of the foetus and can disrupt the development of the lungs and brain.” The prenatal influence of nicotine extends to ‘Sudden Infant Death Syndrome’ (SIDS), to ‘Attention Deficit Hyperactivity Disorder’ (ADHD), emotional problems, as well as the behaviour, thought processes and learning abilities of children. Depression and premature nicotine addiction have been observed later in teenagers.

However, nicotine replacement products are not without their risks even for healthy, non-pregnant adults. They decrease the extensibility of the arteries, cause diseases of the circulatory system, the kidneys and the retina, as well as stomach and duodenal complaints.

Nicotine also causes a variety of cancers. Although it was once considered to be non-carcinogenic, it has since been proven that nicotine promotes an increase in tumour cells and can inhibit them from dying off. “Furthermore, it can also stimulate the regeneration of blood vessels supplying the tumour with blood. All three processes accelerate tumour growth and can therefore cause cancer. Long term nicotine intake could therefore inhibit the regression of the cancer risk which otherwise occurs in patients who successfully quit smoking”, says Professor Schulte-Hermann.

Manfred Neuberger: “We all agree that the tobacco epidemic has to be quit. Yet smoking cannot be overcome without the nicotine dependency being overcome at the same time. However, as long as nicotine products remain generally available and even unborn babies, children and teenagers are exposed to them, nicotine dependency, with all of its tragic consequences for mankind, will continue indefinitely in the future”.

Journal publication: Ginzel KH, Maritz GS, Marks DF, Neuberger M, Pauly JR, Polito JR, Schulte-Hermann R, Slotkin TA 2007. Journal of Health Psychology 12, 2, 215-224.

DOI: 10.1177/1359105307074240.

Published in March 2007

Brief biography:


University Professor, born 1946, Full Professor for Environmental Hygiene at the Medical University of Vienna, Doctorate in Medicine (1971), Specialist in Internal Medicine (1977), Specialist in Hygiene and Preventive Medicine (1980), Specialist in Occupational Medicine (1997). Postdoctoral qualification with the book “New Ways of Assessing the Risks of Air Pollutants” (1980). Deputy Director at the University Institute for Environmental Hygiene. Deputy Medical Director of the Institute for Environmental Medicine for the City of Vienna (1989–99). Since 1992 Head of Department of General Preventive Medicine at the Institute for Environmental Hygiene at the University of Vienna. Consultant to the WHO (IARC, IPCS,ECEH), UNDP, ILO, EU (DG 12, ENSP, ENYPAT), Austrian ministries, Counsellor of Health, ÖBIG, chemical and environmental protection commissions. Director of various scientific associations (e.g.GHUP, IUAPPA, ÖGHMP, GAMED, ASTOX). 374 publications in specialist journals and books specializing in environmental and preventative medicine.

Rolf Schulte HERMANN

University Professor for Toxicology, doctor of medicine, born 1939, pharmacist (Bonn, 1963) and medical doctor (Marburg/D, 1970), postdoctoral qualification in Toxicology and Pharmacology 1975, 1974-1985 Professor at the Philipps-Universität Marburg, 1985 Professor at the University of Vienna, Director of the Cancer Research Institute at the University of Vienna 1985-2004, since 1985 Head of the Department of Toxicology, now Toxicology and Prevention, at the Cancer Research Institute, now Clinical Department for Internal Medicine I. 1991 founding of the Austrian Toxicology Association (ASTOX), since then Chairman of ASTOX, Director of other scientific associations, Director/Member of numerous ministerial and EU commissions, consultant to IARCWHO Lyon, EMEA, Nat. Acad. Sc, USA. 240 publications in peer review journals, a further approx. 200 book contributions including a chapter for toxicology and oncology textbooks. Founder and Head of the University Study Programs for Toxicology (since 1993).