Nicotine gum and self-help behavioral treatment for smoking relapse prevention: Results from a trial using population-based recruitment.

Abstract

Smokers aged 18 to 65 years (N = 1,044) who were able to quit for 24 hr were randomized using a 2 x 2 factorial design to compare nicotine gum to no gum use and self-help materials to no use of materials. All participants were offered a $100 incentive to quit and stay quit for 6 months. Six-month abstinence was 27% in the gum groups, compared with 19% in the no-gum group (p = .002). Compared with the no-gum group, relapse occurred at a significantly lower rate in the gum group for the entire 12 months of follow-up (odds of relapse in the gum group was 0.72, 95% confidence interval, 0.62 to 0.83). There was no significant main effect for the self-help materials, no interaction between gum and materials, and no evidence that the effectiveness of gum differed between the sexes or between heavy and light smokers. Nicotine gum is an effective adjunct to minimal-contact smoking cessation materials plus monetary incentive in a population-based sample of smokers.

Relapse prevention in UK Stop Smoking Services: current practice, systematic reviews of effectiveness and cost-effectiveness analysis.

“…Herd), 12 which increasingly recognise relapse to smoking as a dynamic process difficult to predict and prevent, and likely to involve a complex interaction of factors. 13 Individual factors, such as more dependent smoking, craving, self-efficacy, perceived benefits of smoking, and cues, such as the presence of smokers, situations or behaviours associated with previous smoking, as well as negative effects (e.g. stress), have been shown to trigger lapses and relapse.…”

“…Over time, the use of effective medications has also been added to these strategies. Shiffman 13 recently summarised current thinking suggesting that treatment needed to 'imbue the person with the ability to respond more effectively to a wide range of situational challenges'. However, very few interventions have been shown to be effective for relapse prevention, an issue we discuss further below.…”

“…Of the 14 studies, 40,[63][64][65][66][67][68][69][70][71][72][73][74][75] 13 were carried out within hospitals, clinics or health centres 40,[63][64][65][66][67][68][69][70][71][72][73][74] and one study was conducted within paediatric practices. 73 All provided information on age of participants, smoking history, educational and employment status and eight studies information on race or ethnicity of participants.…”

“…31,[34][35][36][37][38][39]63,67,69,72,[78][79][80]84,[86][87][88][89] urinary or saliva cotinine (six trials), 65,68,70,71,75,81 or saliva thiocyanate (one trial) 40 and nine trials 41,64,66,73,74,76,77,82,85 presented self-reported abstinence only. All studies used a parallel group design except one which was cluster randomised; 41 however, any dependency in the data due to clustering was found to be negligible and, therefore, this study was analysed with the others.…”

The effect of five smoking cessation pharmacotherapies on smoking cessation milestones.

“…This could be due to adherence. Perhaps, as found in other studies of PRN nicotine replacement therapies (Fortmann & Killen, 1995;Glover et al, 1996;Goldstein, Niaura, Follick, & Abrams, 1989), few participants took enough lozenges to reach a therapeutic dose. It is important to note that the nicotine lozenge did boost the efficacy of bupropion and the nicotine patch when taken in combination (Table 2).…”