title: Nicotine patch therapy for smoking cessation combined with physician advice and nurse follow-up. One-year outcome and percentage of nicotine replacement.
abstract: OBJECTIVE
  To determine the efficacy of a 22-mg nicotine patch combined with the National Cancer Institute program for physician advice and nurse follow-up in providing withdrawal symptom relief, 1-year smoking cessation outcome, and percentage of nicotine replacement.
  
  
  METHODS
  Randomized, double-blind, placebo-controlled trial.
  
  
  METHODS
  Two-hundred forty healthy volunteers who were smoking at least 20 cigarettes per day.
  
  
  METHODS
  Based on the National Cancer Institute program, subjects received smoking cessation advice from a physician. Follow-up and relapse prevention were provided by a study nurse during individual counseling sessions. Subjects were randomly assigned to 8 weeks of a 22-mg nicotine or placebo patch.
  
  
  METHODS
  Abstinence from smoking was verified by expired air carbon monoxide levels. Withdrawal symptoms were recorded during patch therapy, and the percentage of nicotine replacement was calculated by dividing serum nicotine and cotinine levels at week 8 of patch therapy by levels obtained while smoking.
  
  
  RESULTS
  Higher smoking cessation rates were observed in the active nicotine patch group at 8 weeks (46.7% vs 20%) (P < .001) and at 1 year (27.5% vs 14.2%) (P = .011). Higher smoking cessation rates were also observed in subjects assigned to the active patch who had lower serum levels of nicotine and cotinine at baseline, and withdrawal symptom relief was better in the active patch group compared with placebo.
  
  
  CONCLUSIONS
  Clinically significant smoking cessation can be achieved using nicotine patch therapy combined with physician intervention, nurse counseling, follow-up, and relapse prevention. Smokers with lower baseline nicotine and cotinine levels had better cessation rates, which provides indirect evidence that they had more adequate nicotine replacement with this fixed dose of transdermal nicotine than those smokers with higher baseline levels.
authors.affiliation: Nicotine Dependence Center, Mayo Clinic, Rochester, MN 55905.
authors.forename: R D
authors.initials: RD
authors.lastname: Hurt
authors.forename: L C
authors.initials: LC
authors.lastname: Dale
authors.forename: P A
authors.initials: PA
authors.lastname: Fredrickson
authors.forename: C C
authors.initials: CC
authors.lastname: Caldwell
authors.forename: G A
authors.initials: GA
authors.lastname: Lee
authors.forename: K P
authors.initials: KP
authors.lastname: Offord
authors.forename: G G
authors.initials: GG
authors.lastname: Lauger
authors.forename: Z
authors.initials: Z
authors.lastname: Marŭsić
authors.forename: L W
authors.initials: LW
authors.lastname: Neese
authors.forename: T G
authors.initials: TG
authors.lastname: Lundberg
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D001944:Breath Tests; D002248:Carbon Monoxide / Q000032:analysis; D003367:Cotinine / Q000097:blood; D003376:Counseling / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009538:Nicotine / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood; D009726:Nurses; D010819:Physician's Role; D012907:Smoking / Q000628:therapy*; D016540:Smoking Cessation / Q000379:methods* / Q000706:statistics & numerical data; D013375:Substance Withdrawal Syndrome / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D009538:Nicotine; D002248:Carbon Monoxide; D003367:Cotinine