In the largest randomised, placebo controlled trial of nicotine patches in general practice we showed that the patch was effective in helping heavy smokers (>=15 cigarettes a day) to stop smoking in the short term.1 Among 1686 patients, rates of confirmed cessation three months after starting to use the patch were 19.4% with nicotine patches and 11.8% with placebo patches. These rates are similar to those reported by the only other randomised trial of a nicotine patch in British general practice.2 Trials of interventions to promote smoking cessation have shown that the effect of the intervention diminishes over time. Typically, about half of those abstinent at three months relapse by the end of a year.3 We report here the smoking cessation rates in our trial one year after the patients began to use the patch. Selection of subjects and methods has previously been reported.1 Briefly, 1686 patients, recruited from 19 general practices in Oxfordshire, were randomised …