Nicotine patch therapy for smoking cessation combined with physician advice and nurse follow-up. One-year outcome and percentage of nicotine replacement.
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.
Hurt
R D
RD
Nicotine Dependence Center, Mayo Clinic, Rochester, MN 55905.
Dale
L C
LC
Fredrickson
P A
PA
Caldwell
C C
CC
Lee
G A
GA
Offord
K P
KP
Lauger
G G
GG
Marŭsić
Z
Z
Neese
L W
LW
Lundberg
T G
TG
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
D009538:Nicotine; D002248:Carbon Monoxide; D003367:Cotinine