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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

NRT cancer link?

PLoS ONE published the results of a study earlier this year that raised concerns about potential co-carcinogenic effects of nicotine in tobacco replacement therapies. The results have been reported in the general media (The Times) and according to Cancer Research UK some of these reports have been alarmist.

The original study assessed the effect of nicotine on cellular samples collected from the mouth or some head and neck cancers in a laboratory setting. Samples were collected from 75 individuals, some of whom already had cancer. The study found that nicotine up-regulated the activity of the FOXM1 gene which plays a role in several types of cancer.

These findings should not be considered conclusive and further work is required to assess the level of any risk posed by oral formulations of nicotine replacement therapy. It is also clear that smoking increases the risk of cancers, including mouth cancer and quitting will reduce this risk.

Action: Clinicians should be aware of this research; patients may need reassurance regarding their use of nicotine replacement products.

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