title: Preferences among four combination nicotine treatments.
abstract: 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.
authors.affiliation: Veteran Affairs Greater Los Angeles (VAGLA) Healthcare System, Los Angeles, CA 90073, USA. ngs@ucla.edu
authors.forename: Nina G
authors.initials: NG
authors.lastname: Schneider
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Koury
authors.forename: Chris
authors.initials: C
authors.lastname: Cortner
authors.forename: Richard E
authors.initials: RE
authors.lastname: Olmstead
authors.forename: Neil
authors.initials: N
authors.lastname: Hartman
authors.forename: Leonard
authors.initials: L
authors.lastname: Kleinman
authors.forename: Andrew
authors.initials: A
authors.lastname: Kim
authors.forename: Craig
authors.initials: C
authors.lastname: Chaya
authors.forename: David
authors.initials: D
authors.lastname: Leaf
mesh_terms: 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
chemical_list: D002638:Chewing Gum; D018722:Nicotinic Agonists; D013607:Tablets; D009538:Nicotine