Health: A Question of Health

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DO NICOTINE patches work?

Nicotine replacement therapy, in the form of chewing-gum, skin patches or tablets that dissolve under the tongue, doubles your success rate if you are trying to give up smoking. If you use willpower alone, you have a 3 per cent chance of giving up smoking for a year or more, but willpower plus nicotine patches (or chewing gum or pills) increases this to 6 per cent. If you go to a clinic to help you stop smoking your success rate is likely to be about 10 per cent, but a clinic plus nicotine replacement puts this up to 20 per cent. A week's supply of nicotine patches costs between pounds 16 and pounds 20, depending on which brand you choose. Serious nicotine addicts may want to try nicotine nasal spray, which is available only on prescription.

I HAVE polymyalgia rheumatica and I will be taking steroid tablets for many months, perhaps years. Can you give me any advice on ways to lessen the unwanted side effects of steroids?

Polymyalgia rheumatica (PMR) causes muscle pains and weakness, but it responds very quickly to steroids. The problem is that, as you say, you will have to take steroids for many months before you are able to stop them completely. The dose of steroids that you will need will probably be quite small, so some of the worst side effects, such as weight gain and "moon face", are unlikely to occur. One side effect of long-term steroid treatment is thinning of the bones - osteoporosis - and you should probably be taking calcium and vitamin D to help prevent bone loss. If you are past the menopause, hormone replacement therapy can be useful.

I HAVE large keloids on my chest which are irritating and ugly. Is laser treatment available for them?

Keloids are scars that overgrow, causing a thick, wide area of scar tissue that is bigger than the original injury. Lasers have been used to remove keloid scars, but the success rate is less than 50 per cent. Another way of treating them is to have triamcinolone injections into the scars. The success rate of this is at least as good as laser treatment.

Please send your questions to A Question of Health, `The Independent', 1 Canada Square, Canary Wharf, London E14 5DL; fax 0171-293 2182; or e- mail to