We could keep them on the patch indefinitely, and call it "nicotine maintenance." There is more than enough justification to claim the same kinds of potential benefits as methadone or suboxone for heroin addicts.

This study simply confirms what other studies of the [in]efficacy of a drug approach to drug use seems to prove, that anti-drug drugs do not affect thought processes and behavior established over years of self-abusive behavior. Not only is the use of drugs ineffective over the long haul, it promotes the notion of addict powerlessness, dependence on outside forces, be they medical or other, to provide a cure. Smoking cigarettes or marijuana or cocaine is ALWAYS a choice, and the cure for making a self-abusive choice is not outside intervention but the counter choice, to choose not to engage in self-abuse. Providing drugs to “cure” the addict only serves to validate drug use, an already established belief by the “addict” to deal with everyday fears and frustrations. I am not advocating the use of a strictly behavioral approach as superior to a pharmacologic one. Both aim to extinguish a targeted behavior. To be effective “treatment” must aim at the total self abuser, must encourage the “addict” to appreciate his/her adequacy in controlling the urge to use, to self-destruct. The battle line is the impulse, and acting on the impulse is always a choice.

I think I read that the abstinence rates for long-term nicotine replacement users and placebo users were "the same a year after the study began". If so, how does this justify their conclusion that longer-term tx is necessary for some smokers? They then say that the success rate for patch users was the same as Chantix users. Again, why the longer term of tx if 2 month's of nicotine replacement tx gets the same results? Furthermore, as Mr. Turner points out, no pharmacological tx will be successful if you don't also address the behavioral components of substance abuse. You have to replace the addictive behavior with something else or people will just fall back into old habits.