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The finding that the levels were similar between exclusive e-cigarette users and non-users (no cigarettes or e-cigarette use) is unexpected, Stokes says, but exclusive e-cigarette use was rare in our sample, so additional studies are needed

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A June 2004 study found that NRT clinical trials were generally not blind as claimed in that "subjects accurately judged treatment assignment at a rate significantly above chance." If clinical trial participants could tell whether or not their nicotine gum or lozenge was delivering nicotine or was instead an empty placebo, it could explain why NRT efficacy is so high in clinical trials yet falls flat on its face the moment it exits the trial clinic's doors

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