Kicking The Habit

By JON D. HULL CHICAGO

Here's a pop quiz sure to make libertarians quiver. Which of the following items cannot be acquired without special permission: a carton of Lucky Strike nonfilters, a liter of grain alcohol, handcuffs, a hypodermic needle or (hint, hint) a nicotine patch?

Yup. The kids can discreetly get their condoms at school, but Mom and Dad must slink off to the doctor's office and pay for permission to attempt to quit smoking with nicotine patches. And that's not all. Even with a prescription, smokers in many states have an easier time purchasing a semiautomatic AK-47 assault rifle -- totally legal, no waiting period -- than certain nicotine patches. The catch? Unlike guns, not only are patches highly regulated, but get this, the two leading brands are being tightly rationed in many areas. For nicotine devotees, walking a mere mile for a Camel seems simple in comparison.

The problem is exquisitely inconceivable. After spending millions of dollars coaxing hundreds of thousands of smokers into making one of the most difficult decisions of their life, the three U.S. patch distributors failed to produce enough to go around. Recent quitters, a high-strung group in the best of times, suddenly found themselves in an unnerving game of musical patches. "It's like a suicide hot line with a busy signal," says Jan Westmier, a former self-described chimney from Berkeley who finally got a supply of patches last month. Seattle carpenter Robert Gould just gave up. "I was on a , waiting list for two weeks before my pharmacy could supply me with the patches," he says. "Hell, by then I'd lost my nerve to quit."

The fuss is remarkable for a product that wasn't even available seven months ago. Nicoderm, the first patch to be approved by the FDA, arrived on the market just in time to cash in on several million New Year's resolutions. Backed by a massive ad campaign, marketer Marion Merrell Dow Inc. quickly created a huge demand, which soon outstripped supply. That was good news for rival Ciba-Geigy Corp., which now claims more than half the market, in contrast to about 30% for Nicoderm. But Ciba-Geigy, which has already sold more than 70 million Habitrol patches, has been forced to curb promotion and ration its product, allowing newcomer ProStep, introduced by American Cyanamid Co., to grab a 13% market share.

Even with overtime production, the patch shortage is expected to last at least until early August. "We're only getting about 50% of what we could sell," says Carolyn Fray, spokeswoman for Rite Aid Corp., which owns 2,498 drugstores nationwide. Merrill Lynch analyst Richard Vietor estimates that sales will top $880 million this year and nearly $1 billion in 1993. (Six months ago, he predicted sales of only $150 million for all of 1992.) "This is overwhelmingly the biggest first-year market for any prescription product," he says.

Priced at under $4 each, the patch delivers a steady fix of nicotine, the addictive part of tobacco, without the 4,000-plus other nasty components that make up tar. Long-term studies are lacking, but initial data suggest that the patches can double the success rate for quitters in the short run when coupled with behavioral therapy.

Now that researchers have developed a relatively benign way to stay hooked on nicotine, will patches become the next big addiction? So far, most researchers see little chance of wide-scale patch abuse, despite reports of patients sneaking extra patches or pressuring physicians to extend treatment beyond the recommended six to 12 weeks. But really, who cares? Nicotine alone is not a killer in modest doses. It mixes just fine with driving, and best of all, co-workers and spouses need not fret about secondary smoke. Until the battle against bad habits is finally won, nicotine patches might just be the most promising candidate for the last socially acceptable -- or at least tolerated -- vice in America.