"Nicotine addiction isn't just a physiological addiction. It's a psychological one, too," said study co-author John P. Pierce, director of the Cancer Prevention and Control Program at the University of California at San Diego Cancer Center. "Unless you handle the problems and the issues that are behind why you're using smoking as a crutch, sooner or later the patch isn't going to work."

The study analyzed data on 15,000 adult smokers taken from the California Tobacco Surveys in 1992, 1996, and 1999.

Pierce and his research team found that in 1992 and 1996, smokers who used anti-smoking patches and gum were more likely than other smokers to quit for long periods of time. However, in 1999, patch and gum users were no more likely than other smokers to remain cigarette-free after three months.

Researchers speculated that the poorer results are due to the fact that the stop-smoking aids no longer require a doctor's approval, meaning counseling is now out of the loop.

But GlaxoSmithKline, the maker of the NicoDerm and Nicorette brands of anti-smoking patches and gum, said that other studies have found that smokers double their chances of quitting by using nicotine-based products, even without counseling.

The findings from Pierce's study are published in the Sept. 11 issue of the Journal of the American Medical Association.

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