Comparison of the effects of combined nicotine replacement therapy vs. cigarette smoking in males

Haustein, Knut-Olaf; Krause, J&#x000F6;rn; Haustein, Heidi; Rasmussen, Thomas Bruun; Cort, N.

doi:10.1080/14622200307227

Cited by 4 publications

(6 citation statements)

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“…Combination therapy did not appear to increase serious adverse events or study withdrawal in comparison to monotherapy. These findings agree with prior research that supported the safety and patient acceptance of combination NRT (e.g., 15, 25, 32, 47, 48). …”

Section: Discussionsupporting

confidence: 92%

A Randomized Placebo-Controlled Clinical Trial of 5 Smoking Cessation Pharmacotherapies

Piper

Smith²,

Schlam³

et al. 2009

Arch Gen Psychiatry

223

241

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Context Little direct evidence exists on the relative efficacies of different smoking cessation pharmacotherapies, yet such evidence is needed to make informed decisions about their clinical use. Objective The primary objective of this research was to assess the relative efficacies of five smoking cessation pharmacotherapy interventions using placebo-controlled, head-to-head comparisons. Design This was a randomized double-blind, placebo-controlled clinical trial. Setting Smokers were recruited from the community at two urban research sites. Patients Participants were 1504 adult smokers who smoked at least 10 cigarettes per day during the past 6 months and reported being motivated to quit smoking. Participants were excluded if they reported: using any form of tobacco other than cigarettes; current use of bupropion; having a current psychosis or schizophrenia diagnosis; or having medical contraindications for any of the study medications. Interventions Participants were randomized to one of six treatment conditions: nicotine lozenge, nicotine patch, bupropion SR, nicotine patch + nicotine lozenge, bupropion + nicotine lozenge or placebo. In addition, all participants received six individual counseling sessions. Main Outcome Measures The main outcome measures were biochemically-confirmed 7-day point-prevalence abstinence assessed at 1 week post-quit, end of treatment (8 weeks post-quit) and 6 months post-quit. Other outcomes were initial cessation, number of days to lapse, number of days to relapse, and latency to relapse after the first lapse. Results All pharmacotherapies differed from placebo when examined without protection for multiple comparisons (OR’s = 1.63–2.34). With such protection, only the nicotine patch + nicotine lozenge (OR = 2.34, p < .001) produced significantly higher abstinence rates at 6-months post-quit than did placebo. Conclusions While the nicotine lozenge, bupropion, and bupropion + lozenge produced effects that were comparable to those reported in previous research, the nicotine patch + lozenge produced the greatest benefit relative to placebo for smoking cessation.

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Section: Discussionsupporting

confidence: 92%

A Randomized Placebo-Controlled Clinical Trial of 5 Smoking Cessation Pharmacotherapies

Piper

Smith²,

Schlam³

et al. 2009

Arch Gen Psychiatry

223

241

View full text Add to dashboard Cite

show abstract

“…However, CO levels were highly correlated with blood levels of the nicotine metabolite cotinine and the association with behavioural and fMRI measures was consequently also observed when blood cotinine levels were considered. Moreover, previous studies have shown that levels of expired CO are highly correlated with blood nicotine levels (Herning et al, 1983;Haustein et al, 2003;Jarvik et al, 2000).…”

Section: Limitations Of the Studymentioning

confidence: 97%

Spatial and sustained attention in relation to smoking status: behavioural performance and brain activation patterns

Vossel¹,

Warbrick

Mobascher³

et al. 2011

J Psychopharmacol

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Nicotine enhances attentional functions. Since chronic nicotine exposure through smoking induces neuroadaptive changes in the brain at a structural and molecular level, the present functional MRI (fMRI) study aimed at investigating the neural mechanisms underlying visuospatial and sustained attention in smokers and non-smokers. Visuospatial attention was assessed with a location-cueing paradigm, while sustained attention was measured by changes in response speed over time. During invalid trials, neural activity within the basal forebrain was selectively enhanced in smokers and higher basal forebrain activity was associated with increased parietal cortex activation. Moreover, higher levels of expired carbon monoxide in smokers before scanning were associated with higher parietal cortex activation and faster responses to invalidly cued targets. Smokers showed a slowing of responses and additionally recruited an area within the right supramarginal gyrus with increasing time on task. Activity decreases over time were observed in visual areas in smokers. The data provide evidence for altered attentional functions in smokers as compared with non-smokers, which were partly modulated by residual nicotine levels and were observed at a behavioural level for sustained and at a neural level for spatial and sustained attention.

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“…The use of NRT was associated with an increased risk for less serious CVD events, such as tachycardia and nonspecific chest pain in a meta-analysis, although major adverse CVD events (MACEs), defined as CVD death, nonfatal MI, and nonfatal stroke, were not taken into consideration [35]. Clinical trials and laboratory research studies have shown that NRT is safe even with a high-dose patch or combination of NRT and concurrent smoking [15,34,36].…”

Section: Nicotine Replacement Therapymentioning

confidence: 96%

Cardiovascular Adverse Events Associated with Smoking-Cessation Pharmacotherapies

et al. 2014

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Smoking continues to be the leading cause of preventable deaths in the USA, accounting for one in every five deaths every year, and cardiovascular (CV) disease remains the leading cause of those deaths. Hence, there is increasing awareness to quit smoking among the public and counseling plays an important role in smoking cessation. There are different pharmacological methods to help quit smoking that includes nicotine replacement products available over the counter, including patch, gum, and lozenges, to prescription medications, such as bupropion and varenicline. There have been reports of both nonserious and serious adverse CV events associated with the use of these different pharmacological methods, especially varenicline, which has been gaining media attention recently. Therefore, we systematically reviewed the various pharmacotherapies used in smoking cessation and analyzed the evidence behind these CV events reported with these therapeutic agents.

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Comparison of the effects of combined nicotine replacement therapy vs. cigarette smoking in males

Cited by 4 publications

References 0 publications

A Randomized Placebo-Controlled Clinical Trial of 5 Smoking Cessation Pharmacotherapies

A Randomized Placebo-Controlled Clinical Trial of 5 Smoking Cessation Pharmacotherapies

Spatial and sustained attention in relation to smoking status: behavioural performance and brain activation patterns

Cardiovascular Adverse Events Associated with Smoking-Cessation Pharmacotherapies

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