by Debra A. Mayer

About the author: Debra A. Mayer is a research associate in epidemiology at the American Council on Science and Health, an association of scientists and physicians concerned with public health.

With much fanfare, the nicotine transdermal delivery system, more commonly known as the “nicotine patch,” was introduced in 1992. Approval by the Food and Drug Administration (FDA) was accompanied by an unprecedented direct marketing campaign by the pharmaceutical industry. In the ads, smokers were urged to ask their physicians about “the patch.” Many heeded this call, with growing numbers reaching for a patch instead of a pack. With both the drug companies and smokers hopeful, nicotine patch sales of more than $1 billion were predicted for 1992.

One year later, the patch no longer appeared to be a “magical cure” for...