Over-the-counter nicotine replacement therapy for everyone: is it the best solution?

The persistent use of different forms of nicotine replacement therapy (NRT) is an under-investigated issue in medical research. While the data concerning the proportion of long-term users in the population of total NRT users seems reassuring at first glance, we must recognize that the small relative numbers (proportions) conceal a population of persistent NRT users with a considerable absolute number of members. Furthermore, only a small amount of data is available concerning the safety of persistent NRT use. At the present time we therefore have no basis for declaring that the population of long-term users are under cover (we are only able to state that persistent use of NRT is undoubtedly safer than the continuation of smoking). Consequently, there is a need to conduct large-scale studies with the primary aim of monitoring for misuse of OTC NRT and assessing the possible physical and mental health risks of persistent NRT use.