Source: Annual Congress 2002 - Smoking prevention and cessation
Disease area: Airway diseases

Abstract

Objective: To determine whether pre-treatment (ptx) with a nicotine patch starting 2 weeks prior to quit date reduces withdrawal symptoms (WS) and increases the success rate of smoking cessation using nicotine replacement.
Methods: 200 healthy smokers (expired carbon monoxide (CO) >= 10 parts per million (ppm)) were recruited by newspaper advertisement. At the screening visit (-2 weeks) subjects were randomly allocated to a 2-week ptx with either active nicotine patch (AP) (n=100) or placebo patch (PP) (n=100). From quit date (week 0) onward all subjects received active nicotine patches for 12 weeks (15 mg daily x 8 weeks, 10 and 5 mg daily for 2 weeks each). Follow-up visits included measurement of CO and counselling at 0, 2, 6, 10, and 26 weeks. During ptx and week 1 and 2 subjects documented daily cigarette (cig) consumption and graded the severity of WS using the Wisconsin scale.
Results: The 200 subjects (45% female) had the following comparable baseline characteristics: mean (range): age: 46.5 (24-78) years, daily cig consumption: 24.8 (15-80), CO: 25.5 (10-53) ppm, packyears: 22.9 (3-110), Fagerström test of nicotine dependence: 6.0 (1-10). There were no significant differences in WS, sustained or point prevalence abstinence rates between the groups. Overall sustained abstinence at 6 months was documented in 34/200 (17%) subjects; 22% and 12% for AP and PP groups, respectively (p=0.060). Two patients died (1 per group, not drug related).
Conclusion: The results of our study indicate that pre-treatment with a nicotine patch before cessation does neither reduce WS nor significantly improve the success rate of smoking cessation with nicotine replacement.

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M. M. Schuurmans, A. H. Diacon, X. van Biljon, A. Westin, B. Landfeldt, C. T. Bolliger (Tygerberg, Cape Town, South Africa; Helsingborg, Sweden). Effect of pre-treatment with the nicotine patch on withdrawal symptoms in smokers subsequently quitting with the nicotine patch: a double-blind randomised controlled trial. Eur Respir J 2002; 20: Suppl. 38, 3825

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