Nicotine gum treatment before smoking cessation: a randomized trial.
BACKGROUND
New ways of improving the efficacy of nicotine therapy need to be explored. We tested whether starting nicotine polacrilex gum treatment 4 weeks before the quit date improved smoking abstinence rates compared with starting treatment on the quit date.


METHODS
An open randomized trial of 314 daily smokers (mean, 23.7 cigarettes/d) enrolled through the Internet and by physicians in Switzerland from November 2005 to January 2007. In the precessation treatment group, participants received nicotine polacrilex gum (4 mg, unflavored) by mail for 4 weeks before and 8 weeks after their target quit date, and they were instructed to decrease their cigarette consumption by half before quitting. In the usual care group, participants received the same nicotine gum for 8 weeks after their quit date and were instructed to quit abruptly. Instructions were limited to a booklet sent by mail and access to a smoking cessation Web site. Results are expressed as self-reported abstinence rates at the end of treatment and as biochemically verified smoking abstinence (cotinine plus carbon monoxide) after 12 months.


RESULTS
Eight weeks after the target quit date, self-reported 4-week abstinence rates were 41.6% in the precessation treatment group and 44.4% in the usual care group (P = .61). One year after the target quit date, biochemically verified 4-week smoking abstinence rates were 20.8% in the precessation treatment group and 19.4% in the usual care group (P = .76).


CONCLUSIONS
Starting nicotine gum treatment 4 weeks before the target quit date was no more effective than starting treatment on the quit date.
Etter
Jean-François
JF
Institute of Social and Preventive Medicine, Faculty of Medicine, University of Geneva, Centre Medical Universitaire, Geneva 4, Switzerland. Jean-Francois.Etter@unige.ch
Huguelet
Philippe
P
Perneger
Thomas V
TV
Cornuz
Jacques
J
D016642:Bupropion / Q000627:therapeutic use; D002638:Chewing Gum; D006801:Humans; D009538:Nicotine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D011109:Polymethacrylic Acids / Q000008:administration & dosage*; D011145:Polyvinyls / Q000008:administration & dosage*; D016540:Smoking Cessation / Q000379:methods*; D061485:Tobacco Use Cessation Devices; D015430:Weight Gain
D002638:Chewing Gum; D011109:Polymethacrylic Acids; D011145:Polyvinyls; D016642:Bupropion; D009538:Nicotine