Real‐world efficacy of prescription and over‐the‐counter nicotine replacement therapy

Shiffman, Saul; Rolf, Clyde N.; Hellebusch, Stephen J.; Gorsline, J.; Gorodetzky, Charles W.; Chiang, Yu-Kun; Schleusener, Debra S.; Marino, Michael E. Di

doi:10.1046/j.1360-0443.2002.00141.x

Cited by 99 publications

(95 citation statements)

References 31 publications

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“…The drug is underused to an extent similar to that seen with oral nicotine replacement. 31 More frequent contacts during the first few weeks of treatment may improve treatment adherence and increase the chance that patients benefit from the medication.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of cytisine in helping smokers quit: systematic review and meta-analysis

Hájek

McRobbie

Myers

2013

Thorax

119

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Background A recent rigorous study has shown that cytisine, a low-cost drug, is effective for smoking cessation. A number of earlier studies exist, mostly from former communist countries where cytisine has been used since the 1960s. The key question now is whether there is sufficient evidence to warrant licensing cytisine or whether more work is needed. A systematic review was undertaken to assess the efficacy of cytisine in smoking cessation. Methods The Cochrane Library, CINAHL, Embase, Medline and PsycINFO databases were searched for relevant data. Data from controlled trials were entered into two separate meta-analyses. The first considered the strictest definition of outcome and longest follow-up from all available studies and the second pooled outcomes from studies with biochemically validated abstinence and follow-up of 6 months or longer. Results Eight controlled trials were identified. Seven trials provided extractable data and, when pooled (first meta-analysis), produced a risk ratio (RR) of 1.57 (95% CI 1.42 to 1.74). Data from two high-quality studies (second meta-analysis) produced a pooled RR of 3.29 (95% CI 1.84 to 5.90). Patients on cytisine reported more gastrointestinal symptoms than patients on placebo (RR=1.76, 95% CI 1.28 to 2.42). There was no difference in overall reports of adverse events and no specific safety concerns emerged. Conclusions Cytisine is an effective treatment for smoking cessation with efficacy comparable to that of other currently licensed treatments. Given its low cost and potential for public health benefit, expedited licensing of cytisine for smoking cessation is warranted. BACKGROUND

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Section: Discussionmentioning

confidence: 99%

Efficacy of cytisine in helping smokers quit: systematic review and meta-analysis

Hájek

McRobbie

Myers

2013

Thorax

119

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“…The switch to OTC status for these products increased the use of NRT in the U.S. by 152% (2), and this increased use has been maintained for several years (3). Several randomized placebo-controlled trials showed the efficacy of the nicotine patch under simulated OTC conditions with minimal behavioral support and product instruction (4)(5)(6), reducing concerns that OTC NRT would not be as effective as prescription NRT (7,8). Better access to NRT was also expected to improve rates of smoking cessation in the U.S. (9).…”

Section: Introductionmentioning

confidence: 99%

The Effect of Over-the-Counter Sales of the Nicotine Patch and Nicotine Gum on Smoking Cessation in California

Reed

Anderson

Vaughn

et al. 2005

Cancer Epidemiology, Biomarkers &Amp; Prevention

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The Food and Drug Administration approved over-thecounter (OTC) sale of nicotine gum and nicotine patches in 1996. We used data from the 1996 California Tobacco Survey to compare the rates of nicotine replacement therapy (NRT) use and smoking abstinence in California for each month during a period immediately preceding and immediately following the OTC availability of nicotine gum and patches. For smokers eligible to report a quit attempt, the proportion making a quit attempt using NRT and the proportion remaining abstinent was calculated for each of the 12 months prior to the survey interview. Multiple regression modeling of quit attempts and abstinence included a term for the number of months between the quit attempt and survey interview and dummy variables for the months before and after the OTC availability of NRT. Results showed a significant increase in the fraction of smokers using the patch (P < 0.01) and gum (P < 0.05) immediately following their availability OTC. There was also a significantly higher proportion of smokers reporting abstinence with gum use (P < 0.01) and a significant increase in reported abstinence with patch use (P < 0.01) during the period of time immediately following the availability of these products without a prescription. The results of this study suggest that removing the prescription status of NRT products resulted in an immediate increase in quit attempts and smoking abstinence with the use of nicotine gum or patches.

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“…Adherence to smoking cessation treatment under these circumstances can be challenging. Within the general population, those who do adhere to recommended treatment usually achieve better cessation outcomes ( Lam, Abdullah, Chan, & Hedley, 2005 ;Shiffman et al, 2002 ). To date , there are no controlled trials among homeless persons of interventions to improve adherence to self-administered medications, such as nicotine replacement therapy (NRT) .…”

Section: Introductionmentioning

confidence: 99%

Smoking Characteristics and Comorbidities in the Power To Quit Randomized Clinical Trial for Homeless Smokers

Okuyemi

Goldade

Whembolua

et al. 2012

Nicotine & Tobacco Research

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in emergency shelters; nearly half had been homeless for more than a year. Nearly all the participants were daily smokers who smoked an average of 20 cigarettes/day. Nearly 40% had patient health questionnaire-9 depression scores in the moderate or worse range, and more than 80% screened positive for lifetime history of drug abuse or dependence. Conclusions:This study demonstrates the feasibility of enrolling a diverse sample of homeless smokers into a smoking cessation clinical trial. The uniqueness of the study sample enables investigators to examine the infl uence of nicotine dependence as well as psychiatric and substance abuse comorbidities on smoking cessation outcomes. IntroductionDespite progress in reducing cigarette smoking in the general U . S . population, smoking rates and related morbidity remain strikingly high among poor and underserved groups. One underserved group generally unreached by smoking cessation interventions is the 3 million persons annually experiencing homelessness in the U nited S tates . The cigarette smoking rate Abstract Introduction: Smoking prevalence in homeless populations is strikingly high ( ~ 70%); yet, little is known about effective smoking cessation interventions for this population. We conducted a community-based clinical trial, Power To Quit (PTQ), to assess the effects of motivational interviewing (MI) and nicotine patch (nicotine replacement therapy [NRT ]) on smoking cessation among homeless smokers. This paper describes the smoking characteristics and comorbidities of smokers in the study.Methods: Four hundred and thirty homeless adult smokers were randomized to either the intervention arm (NRT + MI) or the control arm (NRT + Brief Advice). Baseline assessment included demographic information, shelter status, smoking history, motivation to quit smoking, alcohol/other substance abuse, and psychiatric comorbidities.Results: Of the 849 individuals who completed the eligibility survey, 578 (68.1%) were eligible and 430 (74.4% of eligibles) were enrolled. Participants were predominantly Black, male, and had mean age of 44.4 years ( S D = 9.9), and the majority were unemployed (90.5%). Most participants reported sleeping

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Real‐world efficacy of prescription and over‐the‐counter nicotine replacement therapy

Abstract: Smoking cessation rates achieved with nicotine gum and patch under OTC conditions were as good as those under real-world prescribing conditions.

Cited by 99 publications

References 31 publications

Efficacy of cytisine in helping smokers quit: systematic review and meta-analysis

Efficacy of cytisine in helping smokers quit: systematic review and meta-analysis

The Effect of Over-the-Counter Sales of the Nicotine Patch and Nicotine Gum on Smoking Cessation in California

Smoking Characteristics and Comorbidities in the Power To Quit Randomized Clinical Trial for Homeless Smokers

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