title: A prospective study of off-label use of, abuse of, and dependence on nicotine inhaler.
abstract: OBJECTIVE
  To determine the incidence of off-label use of, abuse of, and dependence on prescription nicotine inhaler.
  
  
  METHODS
  Prospective telephone and internet interviews for six months.
  
  
  METHODS
  535 new inhaler users.
  
  
  RESULTS
  Structured interview about off-label use (that is, use of inhaler for non-cessation reasons or concurrent use of inhaler and cigarettes) and Diagnostic and statistical manual, fourth edition (DSM-IV) and International classification of diseases, 10th edition (ICD-10) criteria for abuse and dependence
  
  
  RESULTS
  Although many used inhaler and cigarettes concurrently at some time (43-55%), few used inhaler for non-cessation reasons (4-9%) and few persisted in off label use (8-16%; 95% confidence interval (CI) 5% to 19%). No participant met ICD-10 criteria for harmful use/abuse (95% CI 0% to 3.3%). Eight subjects (1.4%) appeared to meet DSM-IV or ICD-10 criteria for dependence on inhaler, but none were found dependent in a clinical expert interview (95% CI 0% to 3.3%).
  
  
  CONCLUSIONS
  Although transient concurrent use of inhaler and cigarettes often occurs, use for non-cessation reasons, abuse and dependence are rare.
authors.affiliation: Department of Psychiatry, Psychology & Family Practice, University of Vermont, 38 Fletcher Place, Burlington, VT 05401-1419, USA. john.hughes@uvm.edu
authors.forename: J R
authors.initials: JR
authors.lastname: Hughes
authors.forename: E H
authors.initials: EH
authors.lastname: Adams
authors.forename: M A
authors.initials: MA
authors.lastname: Franzon
authors.forename: M K
authors.initials: MK
authors.lastname: Maguire
authors.forename: J
authors.initials: J
authors.lastname: Guary
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D009538:Nicotine / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D012907:Smoking / Q000523:psychology; D016540:Smoking Cessation / Q000379:methods; D019966:Substance-Related Disorders / Q000523:psychology*
chemical_list: D009538:Nicotine
references.citation: Int J Addict. 1992 Jan;27(1):71-91
references.pmid: 1537641
references.citation: Nicotine Tob Res. 2004 Feb;6(1):177-9
references.pmid: 14982701
references.citation: Drug Saf. 1993 Jan;8(1):49-56
references.pmid: 8471187
references.citation: Addiction. 1994 Jun;89(6):743-54
references.pmid: 8069175
references.citation: Clin Pharmacol Ther. 1995 Mar;57(3):309-17
references.pmid: 7697948
references.citation: Psychopharmacology (Berl). 1997 Apr;130(4):352-61
references.pmid: 9160851
references.citation: Drug Alcohol Depend. 1998 Oct 1;52(2):99-107
references.pmid: 9800139
references.citation: Am J Psychiatry. 1999 Jun;156(6):897-901
references.pmid: 10360129
references.citation: Psychopharmacology (Berl). 2000 Apr;149(3):198-202
references.pmid: 10823399
references.citation: Psychopharmacology (Berl). 2001 Jan 1;153(2):225-30
references.pmid: 11205423
references.citation: Clin Pharmacol Ther. 2001 Mar;69(3):175-83
references.pmid: 11240982
references.citation: Int J Epidemiol. 2001 Jun;30(3):521-5
references.pmid: 11416075
references.citation: Clin Pharmacokinet. 2001;40(9):661-84
references.pmid: 11605715
references.citation: Am J Public Health. 2002 Mar;92(3):437-42
references.pmid: 11867326
references.citation: Addiction. 2002 May;97(5):505-16
references.pmid: 12033652
references.citation: Tob Control. 2003 Sep;12(3):310-6
references.pmid: 12958394
references.citation: Addiction. 2003 Dec;98(12):1747-53
references.pmid: 14651507
references.citation: Nicotine Tob Res. 2004 Feb;6(1):79-84
references.pmid: 14982691
references.citation: Health Psychol. 1992;11(5):331-4
references.pmid: 1425551