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Many therapies for discontinuing smoking exist but most do not work. Now the latest study from the University of Wisconsin indicates that a combination of nicotine patch plus lozenge almost doubles the rate of abstinence at 6 months compared with placebo.
One of the authors of the study, Megan Piper, Center for Tobacco Research and Intervention, School of Medicine and Public Health, says "This is the first time that a head-to-head study has been done looking at all the different smoking cessation pharmacotherapies, and it's also one of the first times that combination therapies have been looked at in a large sample. When you get a 40% quit rate at 6 months in a group, that's really promising for smokers who are trying so hard to quit."
The study looked at 1504 adults who smoked an average of 10 or more cigarettes a day for at least the past 6 months and were randomly assigned to 1 of 6 treatments:
• bupropion SR (Zyban), 150 mg twice
• nicotine lozenge (2 or 4 mg)
• nicotine patch (24-hour, 21, 14, and 7 mg);
• nicotine patch plus nicotine lozenge;
• bupropion SR plus nicotine lozenge;
• placebo
All the participants also received six 10- to 20-minute individual counseling sessions. A carbon monoxide breath test was carried out to determine if smoking was discontinued or relapse had occurred. The researchers used several criteria to measure cessation achievement including being able to stop, time to relapse and so on.
The results
During treatment, the patch, bupropion plus lozenge, and patch plus lozenge were all significantly more effective than placebo, but at 6 months, or 4 months after the end of treatment, only the patch plus lozenge remained effective.
Abstinence from smoking was confirmed by measuring carbon monoxide in the breath. At 6 months, the best results were 40% when using the patch plus lozenges.
Nearly 22 percent of candidates who took the sugar pill also quit smoking. In all the other measures, the patch plus lozenge was tops when compared to other therapies for smoking cessation. All the smoking cessation therapies were safe and well tolerated. Only 4 of 1504 participants withdrew from the study. The study was sponsored by the drug industry.
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