The spat over nicotine therapy is getting still more interesting. Despite concerns that various gimmicks - prescription nicotine inhalers and sprays, to over-the-counter products, such as patches, lozenges and GlaxoSmithKline’s Nicorette gum - are of questionable value, some public-health experts want to ease the warnings.

They worry aloud that smokers are scared off. “A 17-year-old smoker of 25 cigarettes per day is doing the right thing to use nicotine gum,” Jonathan Foulds, a tobacco researcher at University of Medicine and Dentistry of New Jersey, tells The Wall Street Journal (subscription required) in a fascinating look at the issue. “Why give him another hurdle to cross to get help?”

Recent studies of successful quitters suggest significant benefits of nicotine products seen in randomized clinical trials may not apply in real-world conditions. Critics say experts who favor nicotine meds are financially tied to manufacturers to see the limitations. And nicotine use by teens, pregnant women, heart-disease patients and smokers who haven’t quit is controversial.

Meanwhile, studies in rats suggest the fetal brain may accumulate more nicotine from NRT than from smoking, says Theodore Slotkin, professor of pharmacology and cancer biology at Duke University who, conveniently, has a research grant from tobacco giant Philip Morris. He adds that nicotine in the fetal brain is associated with any number of neuro-behavorial problems.

Nancy Rigotti, a Massachusetts General Hospital tobacco researcher who is also a consultant to Pfizer, which makes a nicotine-replacement therapy, dismissed that concern, the Journal reports. “Humans aren’t rats,” she says knowingly.

Wait a second, now. Rats are used in pre-clinical work. But when a drugmaker wants to discuss or defend a medicine, doesn’t it sometimes point to rodent results? Is it possible to want it both ways? Maybe Rigotti is wrong. Maybe some humans really are rats.

[tags]GlaxoSmithKline, Nicotine Therapy, Pfizer, Smoking[/tags]