title: Comparative efficacy of 24-hour and 16-hour transdermal nicotine patches for relief of morning craving.
abstract: OBJECTIVE
  To compare a transdermal nicotine patch designed for 24-hour wear with one designed for 16-hour wear for relief of craving and withdrawal, particularly in the morning hours.
  
  
  METHODS
  Smokers were randomly assigned to use one of two common patch regimens: NicoDerm/NiQuitin (24-hour wear, 21 mg nicotine) or Nicotrol/Nicorette (16-hour wear, 15 mg). In a double-dummy design, participants wore two patches during the day, one active, one placebo and one patch while sleeping.
  
  
  METHODS
  A smoking cessation research clinic.
  
  
  METHODS
  Two hundred and forty-four smokers who suffered morning cravings.
  
  
  METHODS
  Two patch formulations approved and marketed for over-the-counter use in the US--NicoDerm CQ (labeled as 21 mg over 24 hours) and Nicotrol (labeled as 15 mg over 16 hours)--were each used according to its instructions. Smokers also received behavioral counseling.
  
  
  METHODS
  For a week of baseline and 2 weeks after quitting, smokers used palm-top computers to assess craving and withdrawal symptoms several times each day.
  
  
  RESULTS
  The 21 mg/24-hour patch yielded consistently better control of craving, not only during the morning hours, but throughout the day, and over the 2-week period of abstinence. Additionally, the 21 mg/24-hour patch yielded greater reductions in anxiety, irritability and restlessness. Smokers using the 21 mg/24-hour dosing regimen also experienced longer abstinence than those using the 15 mg/16-hour patch.
  
  
  CONCLUSIONS
  These findings demonstrate that 24-hour dosing with a 21 mg patch affords superior relief of craving and withdrawal during the first 2 weeks of abstinence, when symptoms are at their peak, and when relapse is most likely. They confirm the importance of dosing parameters in nicotine replacement products.
authors.affiliation: University of Pittsburgh, Smoking Research Group, PA 15260, USA.
authors.forename: S
authors.initials: S
authors.lastname: Shiffman
authors.forename: C A
authors.initials: CA
authors.lastname: Elash
authors.forename: S M
authors.initials: SM
authors.lastname: Paton
authors.forename: C J
authors.initials: CJ
authors.lastname: Gwaltney
authors.forename: J A
authors.initials: JA
authors.lastname: Paty
authors.forename: D B
authors.initials: DB
authors.lastname: Clark
authors.forename: K S
authors.initials: KS
authors.lastname: Liu
authors.forename: M E
authors.initials: ME
authors.lastname: Di Marino
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000704:Analysis of Variance; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008838:Microcomputers; D008875:Middle Aged; D009538:Nicotine / Q000008:administration & dosage* / Q000627:therapeutic use; D018722:Nicotinic Agonists / Q000008:administration & dosage* / Q000627:therapeutic use; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology; D018709:Statistics, Nonparametric; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy* / Q000523:psychology
chemical_list: D018722:Nicotinic Agonists; D009538:Nicotine