Letter: Success rates for nicotine patches

Sir: Your feature on nicotine patches was timely on the day that Lord Ridley died of lung cancer ('Nicotine substitute therapies not a patch on will-power', 5 March) but misleading in quoting the statistic that 9 out of 10 smokers quit unaided in support of the argument that such aids are irrelevant.

All this figure demonstrates is that until recently nicotine replacement products have not been widely available and therefore only a small proportion of smokers have used and consequently succeeded with them. Of those smokers who make an attempt to stop, fewer than 1 in 100 will be successful using the 'will-power alone' method and unless we can make some advance on this we are likely to see another two million smoking-related deaths over the next 30 years.

Fortunately, clinical trials of nicotine replacement methods in specialist settings show results of between 10 and 30 successes in 100 attempts. Even if success rates fall to 5 in 100 when these products are purchased over the counter and used without specialist support this would still represent massive reductions in smoking deaths. The message to smokers ought to be: try stopping unaided - if you're motivated and determined enough you can buck the statistics; if you fail, give your will- power a helping hand sooner rather than later.

Yours faithfully,

JOHN STAPLETON

Medical statistician

Institute of Psychiatry

London, SE5

9 March