title: Double blind trial of repeated treatment with transdermal nicotine for relapsed smokers.
abstract: OBJECTIVE
  To assess the efficacy and safety of a repeat course of treatment with transdermal nicotine for cessation of smoking in a brief intervention setting.
  
  
  METHODS
  Randomised, double blind, placebo controlled trial with follow up for 26 weeks.
  
  
  METHODS
  629 smokers who had unsuccessfully attempted to stop smoking by using active transdermal nicotine and brief behavioural counselling. Smokers were motivated to quit smoking for a second time and smoked > or = 15 cigarettes a day.
  
  
  METHODS
  Twelve weeks' treatment with active transdermal nicotine patches or placebo and brief counselling at monthly visits.
  
  
  METHODS
  Sustained smoking cessation for the 28 days before the visit at week 12 verified by expired carbon monoxide concentrations.
  
  
  RESULTS
  At 12 weeks 21/315 (6.7%) subjects allocated to active treatment had stopped smoking compared with 6/314 (1.9%) allocated to placebo (absolute difference 4.7%; 95% confidence interval 1.6% to 7.9%; P = 0.003). At 26 weeks the rates were 20/315 (6.4%) and 8/314 (2.6%) (3.8%; 0.6% to 7.0%; P = 0.021). Difficulty in sleeping was reported by 43/179 (24.0%) on active treatment and 19/143 (13.3%) on placebo (P = 0.015). Severe reactions at the site of application were rare (6/322; 1.9%).
  
  
  CONCLUSIONS
  Repeated treatment with transdermal nicotine together with brief counselling can improve the low success rates of smoking cessation in recently relapsed, moderate to heavy smokers. Questions remain about whether more intensive interventions or higher doses of nicotine could be more effective. The likelihood of severe reactions at the site of application with repeated treatment is low.
authors.affiliation: Department of Social and Preventive Medicine, Monash University, Melbourne, Australia.
authors.forename: S G
authors.initials: SG
authors.lastname: Gourlay
authors.forename: A
authors.initials: A
authors.lastname: Forbes
authors.forename: T
authors.initials: T
authors.lastname: Marriner
authors.forename: D
authors.initials: D
authors.lastname: Pethica
authors.forename: J J
authors.initials: JJ
authors.lastname: McNeil
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D003376:Counseling; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009538:Nicotine / Q000008:administration & dosage* / Q000009:adverse effects; D010349:Patient Compliance; D012008:Recurrence; D016540:Smoking Cessation / Q000379:methods*; D016896:Treatment Outcome; D015430:Weight Gain
chemical_list: D009538:Nicotine