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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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Yet the Stanford team had no trouble finding plenty of tobacco and e-cigarette brands hawking their products on pages liked by thousands or tens of thousands of people