Combination Therapies Return Optimal Smoking Cessation Rates


Employing a nicotine patch or bupropion with a nicotine tablet was the most efficient of five therapies tested for promoting smoking abstinence and fending off a lapse or relapse into smoking, according to a potential study of 1,504 tobacco users.

The therapies were "significantly better than placebo in encouraging initial abstinence" and were effectual in precluding relapsing, reported Sandra Japuntich, Ph.D., a postdoctoral associate at Massachusetts General Hospital's Mongan Institute for Health Policy, Boston.

The study's importance lies in its scrutiny of the outcomes of each therapy closer to the smokers' targeted quit dates, she stated.

The placebo-controlled trial sought to describe the consequences on smoking cessation milestones of five pharmacological therapies: nicotine lozenge, nicotine patch, bupropion, bupropion with a nicotine lozenge, and nicotine patch with a nicotine lozenge.

The milestones were one period of 24-hour abstention within 2 weeks of an target quit date, regressing with at least one cigarette, and relapsing into regular smoking for at least 7 continuous days.

A sum of 70% of tobacco users on placebo initially abstained, likened with 92% of those applying a nicotine patch with a lozenge, 86% on bupropion with a lozenge, 81% on bupropion, 81% on a lozenge, and 88% on a nicotine patch.

Of those who initially abstained, 83% on placebo lapsed, compared with 70% those using a patch with a lozenge, 71% on bupropion with a lozenge, 74% on bupropion, 73% on a lozenge, and 76% on a patch.

Of those who lapsed, 69% on place borelapsed, compared with 61% using a nicotine patch, 64% on bupropion with a lozenge, 63% on bupropion, 62% on a lozenge, and 61% on a patch with a lozenge.

The soundest treatment results happened in the initial week or two, she said. Those patients who do not stay abstinent might need to try another therapy.

Dr. Japuntich reported no disputes of interest. One coinvestigator has served on research projects sponsored by a number of pharmaceutical companies.




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