Nicotine patch vs. nicotine lozenge for smoking cessation: an effectiveness trial coordinated by the Community Clinical Oncology Program.
BACKGROUND
Nicotine replacement therapies are efficacious for treating nicotine dependence. However, limited data exist on benefits of different NRTs and predictors of treatment outcome. This study compared the effectiveness of transdermal nicotine vs. nicotine lozenge for smoking cessation and identified predictors of treatment response.


METHODS
A randomized, open-label effectiveness trial was conducted at 12 medical sites participating in the National Cancer Institute's Community Clinical Oncology Program. The sample consisted of 642 treatment-seeking smokers randomized to 12 weeks of transdermal nicotine or nicotine lozenge.


RESULTS
Smoker characteristics were assessed at baseline, and 24-h point prevalence abstinence confirmed with breath carbon monoxide (CO) was evaluated at end of treatment (EOT) and at a 6-month follow-up. There was a trend for higher quit rates for transdermal nicotine vs. nicotine lozenge at EOT (24.3% vs. 18.7%, p=.10) and 6 months (15.6% vs. 10.9%, p=.10). A logistic regression model of EOT quit rates showed smokers who preferred transdermal nicotine, were not reactive to smoking cues, and did not use nicotine to alleviate distress or stimulate cognitive function had higher quit rates on transdermal nicotine. A logistic regression model of 6-month quit rates showed smokers who preferred transdermal nicotine had higher quit rates on transdermal nicotine, and smokers who used nicotine to alleviate distress or stimulate cognitive processes had lower quit rates on nicotine lozenge.


CONCLUSIONS
Transdermal nicotine may be more effective than nicotine lozenge for smokers who prefer transdermal nicotine and do not smoke to alleviate emotional distress or stimulate cognitive function.
Schnoll
Robert A
RA
Department of Psychiatry, University of Pennsylvania, 3535 Market Street, 4th Floor, Philadelphia, PA 19104, USA. schnoll@mail.med.upenn.edu
Martinez
Elisa
E
Tatum
Kristina L
KL
Glass
Marcella
M
Bernath
Albert
A
Ferris
Daron
D
Reynolds
Patrick
P
D000279:Administration, Cutaneous; D000284:Administration, Oral; D000328:Adult; D001944:Breath Tests; D002248:Carbon Monoxide / Q000032:analysis; D003071:Cognition / Q000187:drug effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000008:administration & dosage* / Q000031:analogs & derivatives; D018722:Nicotinic Agonists / Q000008:administration & dosage*; D015143:Philadelphia; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology; D013315:Stress, Psychological / Q000150:complications; D014029:Tobacco Use Disorder / Q000188:drug therapy* / Q000523:psychology; D016896:Treatment Outcome
D018722:Nicotinic Agonists; D009538:Nicotine; D002248:Carbon Monoxide