Effect of transdermal nicotine delivery as an adjunct to low-intervention smoking cessation therapy. A randomized, placebo-controlled, double-blind study.
ABSTRACT To assess the smoking cessation efficacy of transdermal nicotine patches as an adjunct to low-intervention therapy, we conducted a double-blind, placebo-controlled trial in 158 smokers. Participants were randomly assigned to one of the following three study regimens that required daily application of two 15-cm2 patches: (1) 24-hour nicotine delivery, (2) nicotine delivery during wakeful hours only, and (3) placebo. The impact of the three regimens on smoking cessation rates and tobacco withdrawal symptoms was examined. During the last 2 weeks of the trial, 39% of the 24-hour nicotine regimen delivery group, 35% of those on wakeful hour nicotine regimens, and 13.5% of the placebo treatment group achieved abstinence. Self-reported quit rates for the two nicotine patch-wearing regimens, as compared with that for the placebo group, continued to be significantly higher at 6 months. Moreover, compared with placebo, the transdermal nicotine patches significantly reduced tobacco withdrawal symptoms during the first few weeks of quitting. The differences in quit rates and tobacco withdrawal symptoms between the two active groups were not statistically significant. The patches were well tolerated both topically and systemically. We concluded that transdermal nicotine, when used as an adjunct to low-intervention therapy, significantly reduced tobacco withdrawal symptoms and enhanced smoking cessation rates.
Article: Transdermal NicotineDrugs 01/1992; 44(3). · 4.13 Impact Factor
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ABSTRACT: Pharmacotherapies for smoking cessation that can be used in a minimal behavioral intervention setting are urgently needed. The studies described in this article show that the nicotinic antagonist mecamylamine is efficacious when administered in combination with nicotine replacement. Mecamylamine and nicotine have been shown to act in concert to attenuate the rewarding effects of cigarette smoking, reduce craving, and suppress ad lib smoking. Moreover, long-term abstinence rates following nicotine/mecamylamine treatment are roughly two to three times higher than with standard nicotine replacement therapy using nicotine skin patches. In one study, the initiation of mecamylamine treatment prior to the target quit-smoking date was shown to be critical in promoting subsequent continuous abstinence from smoking. The main interpretation of this finding is that smoking in the presence of blockade of reward promotes extinction of smoking behavior, raising the likelihood of successful smoking cessation. Directions for future research are also discussed, including mechanistic studies of nicotinic receptor subtypes affected by nicotine and mecamylamine, as well as assessment of the optimal timing, doses, and route of administration of the two drugs in smoking cessation treatment. Overall, the results show that two classic approaches to the treatment of drug dependence, substitution, and blockade, are not mutually exclusive and in fact can be combined fruitfully in the treatment of nicotine addiction. Drug Dev. Res. 38:243–256 © 1996 Wiley-Liss, Inc.Drug Development Research 07/1996; 38:243-256. · 0.87 Impact Factor
- Zeitschrift für Klinische Psychologie und Psychotherapie 01/2008; 37(1):1-14. · 0.79 Impact Factor