title: Comparison of craving and withdrawal among four combination nicotine treatments.
abstract: OBJECTIVE
  To assess the appearance of craving and withdrawal among four combination nicotine replacement treatments (NRTs).
  
  
  METHODS
  In a crossover trial of NRT preferences, 27 smokers tested 4 combinations of nicotine treatments: 2 mg/4 mg gums + 15 mg patch, 2 mg/4 mg lozenges + 15 mg patch, inhalers + 15 mg patch, and 10 + 15 mg double patch (approximately 25 mg). Overnight abstinence was required prior to (1/2) day testing of each combination. Combination NRTs were used for approximately 6 h/day. Subjects resumed smoking each afternoon. For this report, we used the Smoker Anchored Withdrawal Grid to look at craving and withdrawal scores over 5 days of testing (smoking baseline + four treatment days).
  
  
  RESULTS
  "Urge to smoke" and "total withdrawal" showed a rise from baseline to NRT use for the double patch but not for the three acute + patch conditions. Lozenge/patch scores did not rise from baseline for "craving" and "miss a cigarette" but did for gum/patch, inhaler/patch, and double patch. The best relief occurred for NRTs of choice.
  
  
  CONCLUSIONS
  This was a small but suggestive finding regarding the potential of patch plus adjunct ad lib NRT. With little data on relief with NRT combinations, more systematic tests are needed.
authors.affiliation: Nicotine Dependence Research Unit, Veteran Affairs Greater Los Angeles (VAGLA) Healthcare System, Los Angeles, California 90073, USA. ngs@ucla.edu
authors.forename: Nina G
authors.initials: NG
authors.lastname: Schneider
authors.forename: Chris
authors.initials: C
authors.lastname: Cortner
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Gould
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Koury
authors.forename: Richard E
authors.initials: RE
authors.lastname: Olmstead
mesh_terms: D000328:Adult; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D008297:Male; D009538:Nicotine / Q000008:administration & dosage*; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology; D000074606:Smoking Prevention; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy*
chemical_list: D009538:Nicotine