Experts Envision Market Battle Between Drug and Tobacco Companies
By JOHN M. BRODER

WASHINGTON The increasing popularity of smokingcessation aids like
nicotine gum and skin patches portends intense competition between drug
makers and tobacco companies to deliver smokefree nicotine to millions of
Americans who now smoke, tobacco researchers and market analysts say.

The desire of many smokers to quit and the availability of nonprescription
nicotine replacements pose substantial financial risks for the tobacco
companies and a huge market opportunity for pharmaceutical manufacturers,
these experts say.

As a result, tobacco companies, in addition to selling cigarettes, are
working on alternative devices of their own that deliver nicotine without
the severe health risks of smoking. The drug companies, meanwhile, having
already introduced nicotine gum and the nicotine patch, are now marketing a
nicotine nasal spray and are developing related products, including a
nicotinelaced lollipop.

An article being published on Wednesday in The Journal of the American
Medical Association suggests that while their ultimate goals are different
tobacco companies want to keep their customers for a lifetime, while the
drug companies' products are aimed at weaning them from nicotine the two
giant industries are on a collision course.

"A series of technological, economic, political, regulatory and social
developments augurs a strangebedfellows competition in which these
industries will vie for shares of a new multibilliondollar longterm
nicotinemaintenance market," says the article, titled "The Emerging Market
for LongTerm Nicotine Maintenance."

Pharmaceutical companies contend that their nicotine replacement products
are to be used only temporarily, as a therapeutic aid to help cigarette
smokers kick the habit. And until recently, public health officials had
been unwilling to speak openly about encouraging development of products to
support protracted "nicotine maintenance." Doctors and antismoking
advocates have urged rapid smokingcessation programs or quitting cold
turkey as the only ways to address nicotine addiction.

But the principal author of the report in the journal, Dr. Kenneth E.
Warner of the department of health management and policy at the University
of Michigan's School of Public Heath, said in an interview that it was now
acceptable to begin thinking about longerterm nicotine therapy, perhaps
lasting for years. Such therapy could take the form of a socalled safe
cigarette that delivers nicotine without the lethal byproducts of burning
tobacco. Or it might be one of the nicotine replacement products now
available over the counter, like Nicorette gum or the Nicoderm patch.

"When I first broached this idea three or four years ago, the public health
community's reaction was one of horror," Warner said. "But now a lot of
leading thinkers have become more sympathetic," given the recognition that
longterm use of nicotine alone, whatever its health drawbacks, is by far
preferable to a continuation of smoking.

Warner acknowledged that some health professionals might find the idea of
longterm nicotine use undesirable. But as the cigarette companies and the
drug makers rush to develop new nicotine delivery systems, he said, tobacco
users will have numerous new means of satisfying their nicotine craving.

"I think the time is right to open this debate and do so with no blinders
on," Warner said. "I recognize there are risks associated with this
strategy. If we genuinely make these products more attractive to consumers,
we may induce nicotine addiction among children who do not now smoke
cigarettes because of the danger. There is also the risk that people who
might otherwise have quit smoking will expose themselves to the small risk
of continuing nicotine addiction."

But, he added, a nation of gumchewing nicotine addicts is preferable to
one with millions of cigarette smokers incurring numerous health risks to
themselves and to people who breathe secondhand smoke.

The SmithKline Beecham Corp. is the nation's leading marketer of nicotine
replacement products, selling both Nicorette and Nicoderm through its
Consumer Healthcare division. George M. Quesnelle, Consumer Healthcare's
vice president for medical marketing and sales, said the company had no
intention of marketing its products for longterm use to compete against
the cigarette companies for customers.

Quesnelle said the gum and the patch were intended to be used only for a
10to12 week course of therapy to help end smoking. "We have very opposite
goals from the tobacco companies: to help people quit smoking," he said in
an interview. "We're coming from diametrically opposed views."

Peggy Carter, a spokeswoman for the R.J. Reynolds Tobacco Co., said the
company's officials had not seen the article in the journal and so could
not comment on it.

But she added, "We have never perceived ourselves in competition with drug
companies."