title: High-dose nicotine patch therapy for smokers with a history of alcohol dependence: 36-week outcomes.
abstract: This study reports findings from an investigation of the efficacy of high-dose nicotine patch (NP) therapy for heavy smokers with a history of alcohol dependence. One hundred thirty participants were randomly assigned to 42 or 21 mg of transdermal nicotine. Follow-up assessments were conducted at 4, 12, 24, and 36 weeks. Differences between dose conditions were nonsignificant, although, unexpectedly, outcomes favored participants in the 21-mg NP condition. Nicotine abstinence rates in the 21- and 42-mg NP conditions on Week 36 follow-up were 16.9% and 9.2%, respectively. Patch condition did not interact with severity of nicotine dependence. However, nicotine abstinence at follow-up was related to a longer length of alcohol abstinence. No evidence was found for better outcomes as a function of the percentage of baseline cotinine replaced by NPs. Future research should focus primarily on investigating ways to improve smoking quit rates for smokers in early alcohol recovery.
authors.affiliation: Department of Psychiatry, School of Medicine, Boston University, Boston, MA 02118, USA.
authors.forename: David
authors.initials: D
authors.lastname: Kalman
authors.forename: Christopher W
authors.initials: CW
authors.lastname: Kahler
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: Garvey
authors.forename: Peter M
authors.initials: PM
authors.lastname: Monti
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000437:Alcoholism / Q000150:complications*; D003367:Cotinine / Q000097:blood; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000008:administration & dosage* / Q000627:therapeutic use*; D018722:Nicotinic Agonists / Q000008:administration & dosage* / Q000627:therapeutic use*; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012907:Smoking / Q000188:drug therapy*; D016540:Smoking Cessation; D013997:Time Factors; D014029:Tobacco Use Disorder / Q000523:psychology; D016896:Treatment Outcome
chemical_list: D018722:Nicotinic Agonists; D009538:Nicotine; D003367:Cotinine