Preferences among four combination nicotine treatments.
BACKGROUND
Acute nicotine replacement treatments (NRTs) are disliked or misused, leading to insufficient nicotine intake and poor outcome. Patches provide steady nicotine but are slow and passive. Combining systems may improve efficacy with acute NRTs tailored for compliance.


OBJECTIVE
To test initial reactions to and use preferences among combinations of NRTs.


METHODS
Smokers (n=27) tested four combination NRTs in a 5-day crossover trial: 2/4-mg gum + 15-mg patch (G/P), 2/4-mg lozenges + 15-mg patch (L/P), inhaler + 15-mg patch (I/P), and 10 mg + 15-mg patches (P/P). Subjects rated an NRT combination each day after 5-6 h of use and ranked among the NRTs after testing all treatments.


RESULTS
Double-patches (P/P) were ranked highest for "ease of use", "safety", and "use in public". However, for "help to quit", 70% preferred some form of acute-patch combination (A/P) compared to 30% choosing P/P. For "use under stress" (an immediate need), 93% preferred A/P systems compared to 7% choosing P/P. L/P ranked lowest for "ease of use", I/P and L/P were lowest on "safety", and I/P ranked lowest for "use in public". Expectations of NRTs changed with test experience for patches (better) and lozenges (worse).


CONCLUSIONS
In brief testing, all combinations were acceptable. P/P was favored for ease, safety, and public use, but a majority chose A/P systems for help in quitting and use under stress. Combined use is viable and needs to be made known and accessible to smokers.
Schneider
Nina G
NG
Veteran Affairs Greater Los Angeles (VAGLA) Healthcare System, Los Angeles, CA 90073, USA. ngs@ucla.edu
Koury
Margaret A
MA
Cortner
Chris
C
Olmstead
Richard E
RE
Hartman
Neil
N
Kleinman
Leonard
L
Kim
Andrew
A
Chaya
Craig
C
Leaf
David
D
D000279:Administration, Cutaneous; D000280:Administration, Inhalation; D000284:Administration, Oral; D000328:Adult; D002638:Chewing Gum; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D009538:Nicotine / Q000008:administration & dosage / Q000627:therapeutic use*; D018722:Nicotinic Agonists / Q000008:administration & dosage / Q000627:therapeutic use*; D017060:Patient Satisfaction; D012107:Research Design; D012646:Self Administration; D016540:Smoking Cessation / Q000379:methods*; D013607:Tablets; D013997:Time Factors; D014029:Tobacco Use Disorder / Q000188:drug therapy*; D016896:Treatment Outcome
D002638:Chewing Gum; D018722:Nicotinic Agonists; D013607:Tablets; D009538:Nicotine