Nicotine patches don't cause heartburn

December 19, 1999

Contrary to previous research findings, nicotine patches don't appear to cause heartburn, the results of a small study suggest.

"Previous research that suggested an association between the nicotine patch and heartburn symptoms lacked necessary rigorous study protocols," said lead author of the study Richard A. Wright, MD, MBA. "That study consisted of smokers and non-smokers, rather than a homogenous group of smokers."

Also, diet was not controlled, unlike in the present study. "Thus, some patients could have ingested large amounts of fatty foods, alcohol, etc. which could induce reflux (heartburn symptoms) independently," said Wright.

Nicotine skin patches, also known as transdermal nicotine delivery systems, deliver small steady doses of nicotine through the skin. Patches can help reduce the physical cravings associated with smoking withdrawal, and in recent years they have been widely integrated into programs designed to help smokers quit.

The researchers monitored 20 smokers for three days. During this interval each study participant alternatively wore a placebo patch, a 15 mg. nicotine patch or a 21 mg. nicotine patch.

Wright and colleagues, all from the University of Louisville School of Medicine in Kentucky, worked in collaboration with researchers from McNeil Consumer Products, the Ft. Washington, Pennsylvania-based manufacturer of nicotine patches.

In addition, the previous study had no confirmation of cigarette abstention, whereas in the present study participants were given a carbon monoxide test to confirm that they weren't smoking during the study period.

Smoking itself is associated with heartburn, which results when the valve at the bottom of the esophagus, or swallowing tube, allows stomach acid to splash up into the sensitive lining of the esophagus.

Wright and colleagues found no statistically significant differences between any of the days in terms of the study participants' incidences of heartburn, chest pain, nausea, or difficulty swallowing. Their findings appear in the current issue of Nicotine & Tobacco Research.

Some side effects have been associated with nicotine patches, including nausea, vague stomach pain, and chest discomfort. But these symptoms don't appear to be related to the esophageal condition that causes heartburn, conclude Wright and colleagues. Instead, these symptoms may result from nicotine toxicity, which is known to cause nausea, vertigo and abdominal symptoms.

The study was funded by McNeil Pharmaceuticals.
Nicotine & Tobacco Research is the official peer-reviewed quarterly journal of the Society for Research on Nicotine and Tobacco. For information about the journal, contact Gary E. Swan, PhD, at 650-859-5322.

Posted by the Center for the Advancement of Health <>. For information about the Center, call Petrina Chong, <> (202) 387-2829.

Center for Advancing Health

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