Smoking cessation therapies: which one works best?

Nicotine addiction is one of the most difficult habits to break. That is why researchers are always busy finding ways and means to help people stop smoking. Over the years, many smoking cessation therapies have been developed, including anti-smoking patches, nicotine gums, and nicotine lozenges.

A recent study reports that a combination of two of these therapies may be the best way to break the smoking habit. The study looked at 1504 adults who smoked about 10 or more cigarettes a day during the past 6 months. The study participants were randomly assigned to one of the 6 different smoking cessation therapies:

• bupropion SR (sustained release; Zyban, GlaxoSmithKline), 150 mg twice daily for 1 week before a target quit date and 8 weeks after the quit date;
• nicotine lozenge 2 or 4 mg for 12 weeks after the quit date;
• nicotine patch, 24-hour, 21, 14, and 7 mg titrated down during 8 weeks after quitting
• nicotine patch plus nicotine lozenge;
• bupropion SR plus nicotine lozenge;
• placebo (1 matched to each of the 5 treatments).

All the treatments used in the study except bupropion are available over-the-counter.

In addition, all participants underwent counselling, consisting of 6 individual sessions lasting 10 to 20 minutes. The first 2 sessions were scheduled before cessation.

The results showed that among the 6 treatments, the combination of patch and lozenge was the most effective in helping patients quit smoking, with a 40% quit rate in 6 months. So why is this combi therapy more effective than others? The authors believe it has something to do with the additive effect of the two interventions.

According to researcher Dr. Megan E. Piper, assistant professor, at the Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison

“When you put a patch on, it’s steadily putting nicotine into your blood, and so it’s generally taking the edge off some of your withdrawal all the time,” said Dr. Piper. “But some people have times when they always have a cigarette — after a meal or when stressed at work, for example. These people can use the lozenge instead of going for a cigarette in those moments of intense craving.”

But what about counselling? It helps a lot, too, and plays an important role not only in cessation but in preventing relapse.

Photo credit: stock.xchng

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