A study found that six months after quitting a fifth of people admitted smoking and the rate was not significantly different if they had been given nicotine replacement therapy or not.
In 2011 nicotine replacement therapy cost the NHS £31m in England and Wales and it is thought all smoking cessation services cost around £80m.
A team at Nottingham University’s Centre for Tobacco Control Studies randomly assigned 2591 smokers who had called the NHS quitline for help to stop into four groups.
They received standard support with preset messages at intervals and information materials, standard support plus proactive counselling, and standard support plus nicotine replacement patches for six weeks or a combination of extra support and patches.
Six months later around a fifth of the people in each group admitted they were smoking.
Lead author, Professor Tim Coleman of UKCTCS, said: “This important trial has shed useful light on how telephone quitlines can be used to help smokers wanting to quit.
"I think the results highlight just how hard it is for most people to break their addiction to tobacco and just how powerful and damaging a drug this is.
"On the basis of this study, giving out free nicotine patches and more intensive telephone counselling through the English national quitline just doesn’t seem to work.
"It brings into sharp relief the need to find other ways of using quitlines help smokers give up and so to reduce the terrible effects smoking has on people’s lives and the costly burden to the NHS.”
Large number of smokers did not complete the trial and were assumed to be still be smoking.
The findings were published in the British Medical Journal.
Also some people allocated to receive nicotine patches did not collect them, although the authors said this is not thought to affect the results significantly.
GPs and practice nurses currently prescribe nicotine patches and other replacement methods and this was not tested in the trial.
A previous study has suggested that nicotine replacement therapy, which also comes in the form of inhalers, gum and lozenges, increased the chances of quitting smoking by 70 per cent, in people who smoked ten cigarettes a day.
Three out of four people started smoking again.
In 2010/11 NHS Stop Smoking Services received 788,000 pledges to quit smoking with callers setting a date when they would stop.
Fewer than half of these had successfully stopped six weeks after their date.
A spokesman for the Department of Health said: "The NHS Stop Smoking Helpline currently provides smokers interested in quitting with information and referral to their local stop smoking service. This research does not in any way suggest that the current helpline is ineffective.
"The Coleman study looked at what would happen if the helpline also offered extra services to smokers such as free nicotine patches. It found that there would be little additional benefit so we won’t be adding this to the helpline."