Comparative efficacy of rapid-release nicotine gum versus nicotine polacrilex gum in relieving smoking cue-provoked craving.
OBJECTIVE
Most relapse episodes occur when smokers are confronted with craving provoked by situational cues. Current nicotine gum can help relieve cue-provoked cravings, but faster effects may result in more rapid relief. We tested a prototype formulation of a new rapid-release nicotine gum (RRNG) that provides more rapid release and absorption of nicotine, for its ability to provide faster and better craving relief compared to current nicotine polacrilex gum (NPG).


METHODS
Random assignment to RRNG or NPG, used during a smoking cue provocation procedure. Participants and setting A total of 319 smokers were exposed to a smoking cue in the laboratory by being asked to light but not smoke a cigarette of their preferred brand. Subjects then chewed a piece of 2 mg RRNG (n = 159) or 2 mg NPG (n = 160) according to randomized assignment.


METHODS
Craving assessments were completed at regular intervals before and after cue exposure (baseline, pre-cue, and 3, 6, 9, 12, 15, 18, 21, 25, 30 and 35 minutes after the cue).


RESULTS
Smokers chewing RRNG showed significantly lower craving than NPG subjects starting with the first assessment at 3 minutes (P < 0.025). Repeated-measures ANOVA revealed a significant treatment x time interaction (P < 0.05)-craving scores dropped more rapidly in RRNG subjects compared to NPG subjects. Survival analyses also indicated superiority of RRNG in achieving more rapid self-reported meaningful relief (P < 0.05) and complete relief (P < 0.05) of craving.


CONCLUSIONS
Rapid-release nicotine gum reduced cue-provoked craving more rapidly compared to NPG, and thus merits further study in cessation efficacy trials.
Niaura
Raymond
R
Brown Medical School, Providence, RI 02906, USA. niaura@brown.edu
Sayette
Michael
M
Shiffman
Saul
S
Glover
Elbert D
ED
Nides
Mitch
M
Shelanski
Morris
M
Shadel
William
W
Koslo
Randy
R
Robbins
Bruce
B
Sorrentino
Jim
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D002638:Chewing Gum; D003463:Cues; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000008:administration & dosage* / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D011109:Polymethacrylic Acids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D011145:Polyvinyls / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D061485:Tobacco Use Cessation Devices; D014029:Tobacco Use Disorder / Q000534:rehabilitation*; D016896:Treatment Outcome
D002638:Chewing Gum; D011109:Polymethacrylic Acids; D011145:Polyvinyls; D009538:Nicotine