title: A comparison of the abuse liability and dependence potential of nicotine patch, gum, spray and inhaler.
abstract: BACKGROUND
  Nicotine replacement therapy (NRT) in varying forms is becoming widely used. Clinicians, therapists and regulatory authorities are interested in the abuse liability and dependence potential of the different forms.
  
  
  OBJECTIVE
  To compare the abuse liability and dependence potential of nicotine gum, transdermal patch, spray and inhaler.
  
  
  METHODS
  504 male and female smokers seeking help with stopping smoking were randomly allocated to the four products. Measures were taken at the designated quit date, then 1 week, 4 weeks, 12 weeks and 15 weeks later. Smokers were advised to use the product for up to 12 weeks. Those still using the product at the 12-week visit were advised to cease use by week 14. Measures included: pleasantness and satisfaction ratings at weeks 1 and 4 (used as a marker of abuse liability); ratings of feeling dependent on NRT at weeks 1, 4, 12 and 15 (used as a marker of subjective dependence); mood and physical symptoms ratings at weeks 12 and 15 (the change being used to assess physical dependence on NRT), continued usage of NRT at week 15 (used as an marker of behavioural dependence).
  
  
  RESULTS
  Average ratings of pleasantness were low. The nicotine patch was rated as less unpleasant to use than all other products. There were no significant differences between the products in terms of satisfaction or subjective dependence except at week 15 when no patch users rated themselves as dependent. Continued use of NRT at week 15 was related to rate of delivery of nicotine from the products - 2% for patch, 7% for gum and inhaler, 10% for spray (P<0.05 for linear association). Among those
authors.affiliation: St George's Hospital Medical School, London, UK. r.west@sghms.ac.uk
authors.forename: R
authors.initials: R
authors.lastname: West
authors.forename: P
authors.initials: P
authors.lastname: Hajek
authors.forename: J
authors.initials: J
authors.lastname: Foulds
authors.forename: F
authors.initials: F
authors.lastname: Nilsson
authors.forename: S
authors.initials: S
authors.lastname: May
authors.forename: A
authors.initials: A
authors.lastname: Meadows
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D016739:Behavior, Addictive / Q000523:psychology*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D018678:Cholinergic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D009538:Nicotine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011109:Polymethacrylic Acids / Q000627:therapeutic use*; D011145:Polyvinyls / Q000627:therapeutic use*; D012907:Smoking / Q000188:drug therapy* / Q000523:psychology; D061485:Tobacco Use Cessation Devices
chemical_list: D000697:Central Nervous System Stimulants; D018678:Cholinergic Agents; D011109:Polymethacrylic Acids; D011145:Polyvinyls; D009538:Nicotine