Premium
Efficacy of a nicotine inhaler in smoking cessation: a double‐blind, placebo‐controlled trial
Author(s) -
Schneider Nina G.,
Olmstead Richard,
Nilsson Fredrik,
Mody Freny Vaghaiwalla,
Franzon Mikael,
Doan Kim
Publication year - 1996
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1046/j.1360-0443.1996.91912935.x
Subject(s) - inhaler , medicine , cotinine , smoking cessation , placebo , abstinence , nicotine , anesthesia , nicotine gum , asthma , psychiatry , alternative medicine , pathology
A non‐combustible nicotine inhaler, administered orally, has been developed for treatment of smokers. The inhaler allows weaning from nicotine while maintaining partial reinforcement of the ritual/sensory phenomena of smoking. Subjects were randomly assigned to active (n=112) and placebo (n=111) groups. Some behavioral intervention occurred as a function of participation. Strict abstinence (primary outcome criterion) was defined by CO 8 ppm with no slips allowed at any time and cotinine values 14 at 1 year. Survival analysis showed active inhaler was superior to placebo (p0.01). Active vs. placebo success rates were: 63% vs. 47% (day 3), 46% vs. 28% (week 1), 36% vs. 19% (week 2), 33% vs. 16% (week 3), 29% vs. 14% (week 6), 24% vs. 10% (3 months), 17% vs. 9% (6 months) and 13% vs. 8% (1 year). chi2 analyses were significant through 3 months but not at 6 months (p0.08) or 1 year. Craving was relieved with active inhalers at day 3 and week 1. Subjects averaged six inhalers/day. Cotinine levels were 57‐61% of smoking levels. Common side effects included throat/mouth irritation and coughing. Failure was predicted by early slips. The inhaler is clearly useful for short‐term smoking cessation with potential for long‐term efficacy. Extended access to the inhaler and relapse prevention training could improve success rates. Another promising approach would be to combine the inhaler with a nicotine patch.