Matching high- and low-dependence smokers to self-help treatment with or without nicotine replacement.
BACKGROUND
This study investigated the effect of matching smokers to nicotine replacement therapy (nicotine gum) on the basis of the pretreatment level of nicotine dependence.


METHODS
One hundred seventy-three smokers, classified as high or low on nicotine dependence using the Fagerstrom Tolerance Questionnaire, were assigned at random to receive nicotine gum (2 mg), chewed ad libitum, or to not receive nicotine gum. All smokers participated concurrently in a 5-week treatment program consisting of four brief counseling sessions combined with a self-help manual provided by the American Lung Association.


RESULTS
Results showed that smokers with high levels of nicotine dependence were significantly more likely to quit smoking during treatment if they received nicotine gum (31.9%) than high-dependence smokers who did not receive the gum (12.2%). There was a tendency for smokers with low levels of nicotine dependence to do worse during treatment if they received gum (13.5% quit) than they did when they received no gum (20% quit), although this difference was not statistically significant. The relative differences in outcomes persisted after 1 year of follow-up, but the high overall rate of relapse (92.5%) rendered the absolute size of the differences statistically insignificant.


CONCLUSIONS
The results of the study are discussed in terms of strategies that might improve the success of treatment-matching approaches with newer forms of nicotine replacement therapies.
Miriam Hospital/Brown University School of Medicine, Providence, Rhode Island.
R
R
Niaura
M G
MG
Goldstein
D B
DB
Abrams
D000328:Adult; D002638:Chewing Gum; D002985:Clinical Protocols; D003131:Combined Modality Therapy; D003376:Counseling / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008297:Male; D009538:Nicotine / Q000627:therapeutic use*; D012008:Recurrence; D012017:Referral and Consultation; D012648:Self Care / Q000379:methods*; D012720:Severity of Illness Index; D014029:Tobacco Use Disorder / Q000145:classification / Q000628:therapy*; D016896:Treatment Outcome
D002638:Chewing Gum; D009538:Nicotine