Statement of the American Lung Association on A Prospective Cohort Study Challenging the Effectiveness of Population-Based Medical Intervention for Smoking Cessation

Washington, D.C. (January 10, 2012)

The American Lung Association finds this to be an interesting study but urges the media and the public to view the role of nicotine replacement therapy (NRT) within the larger context of tobacco addiction and cessation. While this study examined the effect of NRT on relapse, the Lung Association believes NRT’s main role to be at the beginning of a quit attempt, helping the smoker wean him- or herself away from the nicotine in tobacco.

The American Lung Association does agree strongly with the authors of this study that the best way to reduce tobacco use in the U.S. is to implement evidence-based practices, which include states investing in tobacco prevention programs, increasing tobacco taxes and implementing smokefree laws. These practices, which have been outlined in the Centers for Disease Control and Preventions’ Best Practices for Comprehensive Tobacco Control Programs, have been proven to reduce the number of youth who begin smoking and to increase the number of current smokers who successfully quit in state after state where they’ve been implemented.

There are physical, mental and social aspects to nicotine addiction, and nicotine replacement therapy is only meant to address the physical addiction. Behavioral counseling and social support help to address the mental and social components of tobacco dependence and it is these two factors that are likely to be more important in relapse prevention over time (the main issue examined by this study). A comprehensive approach to smoking cessation that addresses all three components of a smoker’s addiction is key to avoiding relapse and achieving long-term success.

 “Given the billions of dollars and the decades spent by the tobacco industry to make the most addictive cigarette possible, it is no surprise that we have yet to find a simple solution for quitting smoking,” said Norman H. Edelman, M.D., chief medical officer of the American Lung Association. “There’s no single technique that’s likely to help every smoker quit. That’s why the American Lung Association advocates for an overall public health approach to quitting smoking—which includes access to all seven FDA-approved medications and all three forms of counseling with as few barriers to access as possible. Well-established public health measures including high cigarette taxes and comprehensive smokefree air laws provide the context to maximize the effectiveness of these cessation techniques.”

In their study, Alpert et al. argue that public dollars should be used to fund comprehensive tobacco control programs—including cessation services—but that providing free medications to smokers should not come at the expense of these public health programs. In that regard, we agree: states must offer cessation services in a comprehensive way and create an environment with higher taxes, prevention efforts and smokefree laws—an environment that truly supports quitting smoking.


About the American Lung Association
The American Lung Association is the leading organization working to save lives by improving lung health and preventing lung disease, through research, education and advocacy. The work of the American Lung Association is focused on four strategic imperatives: to defeat lung cancer; to improve the air we breathe; to reduce the burden of lung disease on individuals and their families; and to eliminate tobacco use and tobacco-related diseases.  For more information about the American Lung Association, a holder of the Better Business Bureau Wise Giving Guide Seal, or to support the work it does, call 1-800-LUNGUSA (1-800-586-4872) or visit: