A randomized, controlled trial to assess the efficacy and safety of a transdermal delivery system of nicotine/mecamylamine in cigarette smokers

Glover, Elbert D.; Laflin, Molly T.; Schuh, Kory; Schuh, Leslie M.; Nides, Mitch; Christen, Arden G.; Glover, Penny N.; Strnad, Julia V.

doi:10.1111/j.1360-0443.2007.01763.x

Cited by 34 publications

(21 citation statements)

References 25 publications

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“…Although the short-term abstinence rates reported here are much lower than would be expected from NHS Stop Smoking Services , they are in line with other research in which similarly strict definitions of continuous abstinence (i.e., not even a puff) were used (e.g., Glover et al, 2007). Using this sample of smokers had benefits and drawbacks.…”

Section: Discussionsupporting

confidence: 81%

Motives for smoking and their correlates in clients attending Stop Smoking treatment services

McEwen

West

McRobbie

2008

Nicotine & Tobacco Res.

103

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This study investigated smokers' ratings of putative smoking motives and how these relate to smoking patterns, withdrawal symptoms, and short-term abstinence in clients attending smokers' clinics. Data were collected from 2,727 clients from two London Stop Smoking Services that offered behavioral support combined with pharmacotherapy. On a scale of 1 to 5, stress relief (M = 3.9), boredom relief (3.7), and enjoyment (3.6) were rated highest. Uses as an aid to concentration (2.9), for relief of withdrawal discomfort (2.8), and as an aid to socialization (2.8) received moderate ratings. Weight control was rated low (2.0). These ratings were found to be largely independent of each other. Ratings of enjoyment, boredom relief, improvement in concentration, and relief of withdrawal discomfort were positively correlated with daily cigarette consumption (p<.001). Ratings of smoking for withdrawal relief, enjoyment, improvement in concentration, stress relief, and boredom relief were positively correlated with nicotine dependence as measured by the Fagerström Test for Nicotine Dependence (p<.001). Strength of urges to smoke and time spent with urges to smoke in the first week of abstinence were positively correlated with smoking for withdrawal relief, to stay alert, to improve concentration, and with enjoyment of smoking (p<.01). Relapse to smoking within 4 weeks was not associated with ratings of any of the smoking motives, including enjoyment. Although correlated with a measure of dependence, no strong connection appears to exist between relapse and any of the smoking motives, suggesting that the mechanisms underlying nicotine dependence lie at a deeper level, outside the ability of smokers to be introspective regarding their motivations.

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Section: Discussionsupporting

confidence: 81%

Motives for smoking and their correlates in clients attending Stop Smoking treatment services

McEwen

West

McRobbie

2008

Nicotine & Tobacco Res.

103

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“…In addition to a7-nAChR-specific antagonists, a9-nAChR-specific antagonists reduce ascending afferent excitatory pain pathway signaling and have been shown to have analgesic effects in in vivo studies (50,84). As shown in Table 1, several nicotinic antagonists have either launched or entered phase II clinical trials (85,86). Unfortunately, most of these antagonists can also cause a variety of side effects resulting from the lack of nAChR subtype specificity.…”

Section: Nachr Antagonists As Potential Agents For Molecular Cancer Tmentioning

confidence: 99%

Nicotinic Acetylcholine Receptor-Based Blockade: Applications of Molecular Targets for Cancer Therapy

Lee

2011

Clinical Cancer Research

103

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The nicotinic acetylcholine receptor (nAChR) was first characterized in 1970 as a membrane receptor of a neurotransmitter and an ion channel. nAChRs have been shown to be involved in smoking-induced cancer formation in multiple types of human cancer cells. In vitro and in vivo animal studies have shown that homopentameric nAChR inhibitors, such as methyllycaconitine and a-Bgtx, can attenuate nicotine-induced proliferative, angiogenic, and metastatic effects in lung, colon, and bladder cancer cells. Recent publications have shown that a9-nAChR is important for breast cancer formation, and in many in vivo studies, a9-nAChR-specific antagonists (e.g., a-ImI, a-ImI, Vc1.1, RgIA, and It14a) produced an analgesic effect. Vc1.1 functions in a variety of animal pain models and currently has entered phase II clinical trials. For cancer therapy, natural compounds such as garcinol and EGCG have been found to block nicotine-and estrogeninduced breast cancer cell proliferation through inhibition of the a9-nAChR signaling pathway. A detailed investigation of the carcinogenic effects of nAChRs and their specific antagonists would enhance our understanding of their value as targets for clinical translation.

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“…Initial work on precessation treatment revealed that mecamylamine increased the efficacy of patch therapy toward 47.5% to 58% (from 27.5% to 29% when used without mecamylamine) [39]. However, a recent multisite controlled study showed that effect to be minimal at best [40]. Furthermore, the often intolerable side effects of mecamylamine, such as postganglionic effects (eg, orthostatic hypotension) and strong anticholinergic effects (eg, dry mouth and constipation) have limited its use to research settings.…”

Section: Nicotine Antagonistsmentioning

confidence: 98%

Pharmacotherapy for tobacco cessation: Nicotine agonists, antagonists, and partial agonists

Karam‐Hage

Cinciripini²

2007

Curr Oncol Rep

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Nicotine replacement therapies (NRT) were the main pharmacologic option for treatment of nicotine dependence until the early 1990s, when controlled clinical trials confirmed the efficacy of bupropion, the first treatment not based on nicotine. Varenicline, a partial agonist at nicotine receptors, gained US regulatory approval in 2006 for smoking cessation. Although these agents are all effective for nicotine dependence, their efficacy rates vary compared with placebo (overall OR for NRT efficacy, 1.77; for bupropion, 1.94; for varenicline, 3.09). Each of these treatments has a place, sometimes in combinations with other agents, in cancer patients who continue to smoke. Our initial experience with varenicline has been encouraging. Bupropion has specific advantages for cancer patients, including increased energy, low risk for nausea, and decreased weight gain from quitting.

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A randomized, controlled trial to assess the efficacy and safety of a transdermal delivery system of nicotine/mecamylamine in cigarette smokers

Abstract: If adding mecamylamine to nicotine replacement therapy (NRT) improves the chances of success at stopping smoking, the results of this study suggest that the effect is very small.

Cited by 34 publications

References 25 publications

Motives for smoking and their correlates in clients attending Stop Smoking treatment services

Motives for smoking and their correlates in clients attending Stop Smoking treatment services

Nicotinic Acetylcholine Receptor-Based Blockade: Applications of Molecular Targets for Cancer Therapy

Pharmacotherapy for tobacco cessation: Nicotine agonists, antagonists, and partial agonists

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