Effect of nicotine vapour inhalation on the relief of tobacco withdrawal symptoms

Abstract

Fifteen subjects participated in a randomised, placebo-controlled cross-over study to assess the effect of a nicotine vapour inhaler on craving and other withdrawal symptoms during a two-day smoking-free period. Craving and withdrawal symptoms were rated nine times over the two-day period on 10 cm visual analogue scales. Plasma nicotine concentrations in the afternoon of each study day were determined. The results show that active treatment was significantly superior to placebo in decreasing craving and other withdrawal symptom scores. No difference was found between two inhalation techniques, one with shallow, frequent inhalations (buccal technique), and the other with deep inhalations (pulmonary technique). The average number of active nicotine vapour inhalers and placebo inhalers used during the two-day sessions was 12 and 11, respectively. Afternoon plasma nicotine levels of approximately 7 ng/ml were obtained with both inhalation techniques. A strong correlation was found between the afternoon plasma nicotine levels and craving, a high nicotine level being associated with a low craving score. The study has provided information about how to use the nicotine vapour inhaler that could have important implications if it were to be approved for the treatment of tobacco dependence. The use of withdrawal symptom reduction as a surrogate end-point is discussed.

Comparison of Nicotine Pharmacokinetics in Healthy Japanese Male Smokers Following Application of the Transdermal Nicotine Patch and Cigarette Smoking

“…17) Typical trough concentrations during daily smoking are 10 to 37 ng/ml, and typical peak concentrations range between 19 and 50 ng/ml. 24,[34][35][36][37] The mean increase in nicotine levels that occurs after smoking a single cigarette was 10.9 ng/ml in smokers with no smoking abstinence on the study day. 38) Our nicotine concentration data during smoking were within the range of these values, but close to the upper range.…”

Randomised trial investigating effect of a novel nicotine delivery device (Eclipse) and a nicotine oral inhaler on smoking behaviour, nicotine and carbon monoxide exposure, and motivation to quit

“…The nicotine concentration of 3–6 mg/l is much lower than that found in the mainstream smoke of a cigarette. The descriptor “inhaler” is somewhat inappropriate since only very tiny amounts of nicotine are absorbed in the lungs14; instead nicotine is absorbed bucally like nicotine gum. Blood concentrations of nicotine resulting from use of the inhaler are typically half of that derived from cigarettes 14.…”

The scientific foundation for tobacco harm reduction, 2006-2011

“…In 1995 another study by Lunell et al found that 80% of participants preferred shallower puffing for nicotine inhalers, and only 13% favored deeper inhalation [84]. They also observed that a placebo inhaler containing no nicotine resulted in partial suppression of some withdrawal symptoms such as irritability and difficulty in concentrating.…”